The main concern behind writing this project is to understand hospital management in depth together with knowledge of cleft lip and cleft palate deformity. As cleft deformity is one of the most pandemic deformities found with other diseases. But it has not been given much attention as governments and other healthcare organizations have given in preventing and understanding other diseases and deformities.

1. Hospital Management Cleft Deformity –Lip & Palate
Brief from write up:
The main concern behind writing this project is to understand hospital management in depth
together with knowledge of cleft lip and cleft palate deformity. As cleft deformity is one of the
most pandemic deformities found with other diseases. But it has not been given much attention
as governments and other healthcare organizations have given in preventing and understanding
other diseases and deformities.
Diseases and other ailments are on high these days, technology is changing at an unimaginable
speed. It has changed people’s live style and other activities drastically. New generation is least
bothered about the healthcare issues and they accept what comes in front of them without giving
any second thought about affect of their action or routine in future.
Simultaneously to know more about the cleft lip and palate deformity and its consequences at
whole. What are the types of cleft lip and cleft palate that is affecting children worldwide? Its
consequences could sometimes results into the death also, if not treated and directed for safety
measures at right time.
1. What is cleft lip and cleft palate
Cleft lip and cleft palate
Cleft lip, also known as cheiloschisis, and cleft palate, also known as palatoschisis, are types of
abnormal development of the face during the development of the fetus. They are types of
congenital deformities. It can occur as cleft lip or cleft palate and together as cleft lip and cleft
palate.
Cleft lip
This is when the deformity affects the lip only not the palate. Cleft may be small and results in an
indentation on the lip. In some cases, it does not limit to the lip, it may go all the way to the nose.
A slight cleft is known as a partial or incomplete cleft. A complete cleft goes all the way to the
nose.
Cleft palate
This is when the two parts of the skull which form the hard palate are not fused together, the soft
palate also has a gap (cleft). A complete cleft palate may results into a gap in jaw, while an
incomplete cleft palate looks like a hole in the roof of the mouth (cleft soft palate)

2. Cleft lip or palate defects are found to be more common in Caucasian and Asian babies,
compared to babies of African descent. Just cleft palate is more common in females, while the
combination of cleft lip and palate is more common in males. Half of all children born with such
defects have the combination cleft lip and palate, while the rest are evenly divided.
Most cleft can be categorized into three following groups:
1. cleft lip without a cleft palate
2. cleft palate without a cleft lip
3. cleft lip and cleft palate together
It is important to know that the risk of occurrence of Isolated Cleft Palate (ICP) and Cleft Lip /
Cleft Palate (CL/CP) is very different (refer table 1) with Cleft Lip / Cleft Palate being far more
common. Moreover multiple malformations are far more likely in ICP (42%) as compared to
CL/CP where multiple malformations syndromes occur only in 14%.
The most common associated disorder with ICP is the Pierre Robin variant while the most
frequently occurring syndrome is Stickler syndrome (17 % of syndromic clefts, autosomal
dominant, severe myopia, retinal detachment, and glaucoma).
Physical problems & symptoms
Cleft deformity is not responsible for only one problem, but it brings a pack of problems for the
one who born with cleft deformities. After baby born with cleft, it requires lots of care from their
parents and doctors, in terms of feeding guidelines and lots of the trainings and help to their
family to bring their child up with no infection and malnutrition. So it becomes hard job to take
extra care for such babies.

3. >Social stigma, Upper respiratory tract infections Development, Feeding problem, Low self-
esteem, Facial appearance, Ear infections, Speech problems, Tooth development, Speech
problems, Partial hearing loss
Awareness about this congenital deformity
There is very poor awareness about cleft deformity among people or in communities. It’s a fact
that it’s one of the dominating deformity conditions that is affecting every 1 child born in 600
annually. It is fourth most common birth defect in the U.S. Cleft occurs more often in children of
Asian, Latino or Native American descent. Compared with girls, twice as many boys have a cleft
lip, both with or without a cleft palate. However, compared with boys, twice as many girls have
cleft palate without a cleft lip.
It is right that conditions like cancer, tuberculosis, AIDs etc. are also playing havoc in terms of
death around the world. One such deformity is called cleft lip and cleft palate that is affecting
many children around the world and leading to severe infections and even death. It has been
evidenced that even government is least bothered about such conditions and this deformity has
not fetched much attention for the prevention and in terms of safety. Somehow NGOs and
centers are able to provide free of surgeries to the needy people from our society. This has helped
a lot in re integrating them into their life style.
Etiology
The exact cause for cleft lip and cleft palate is not known. But it has been asserted with the help
of several studies done in support to answer the real cause of these deformities that,
environmental, genetic chromosomal factors may be responsible for the occurrence of this
anomaly with all its variations.
It has been thoroughly studied on animals too, and results have posited that experiments have
developed clefting in the offspring by varying diets, drug exposures, radiation and vitamin
dosages.
It has been postulated that a protective influence in the prevention of cleft lip and cleft palate
formation with the folic acid supplementation before and during the first trimester is now being
into effective step. Families known to be at the risk for clefting have also been used for studies.
Types of cleft Lip & Palate
Cleft lip types
Forme fruste unilateral cleft lip
A subtle cleft on one side of the upper lip, which may appear as a small indentation.
Incomplete unilateral cleft lip
A cleft on one side of the upper lip, which does not extend into the nose.
Complete unilateral cleft lip
A cleft on one side of the upper lip, which extends into the nose.

4. Incomplete bilateral cleft lip
Clefts on both sides of the upper lip, not extending to the nose.
Complete bilateral cleft lip
Clefts on both sides of the upper lip, extending into the nose.
Cleft palate types
Incomplete cleft palate
A cleft in the back of the mouth in the soft palate.
Complete cleft palate
A cleft affecting the hard and soft parts of the palate. The mouth and nose cavities are
exposed to each other.
Submucous cleft palate
A cleft involving the hard and/or soft palate, covered by the mucous membrane lining the
roof of the mouth. May be difficult to visualize.
Causes for the deformity
There is no fixed factor for such deformities and in most of the cases, the cause for the cleft lip
and cleft palate is unknown. But many factors are there that gives rise to a cleft child during fetus
formation. Researchers have been trying to find the exact cause of the deformity in individual,
but still it has not been proved for one particular cause. As there are several factors and
conditions that plays role in the formation of fetus with cleft lip or palate or with both. Most
scientists supports cleft are due to the combination of genetics and environmental factors. There
appears to be a greater probability of appearing cleft in child if, sibling, parent or relative has had
the problem.
Some factors that play role in the formation of cleft child are as follows:
Hereditary
Environmental
Consanguineous marriages
Syndromic cases
Smoking and alcohol abuse
Use of drugs or steroids during pregnancy or before
Deficiency of folic acid in women’s diet during pregnancy
Exposure to some viruses or chemicals while the fetus is developing in the womb.
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