presented by HAFIZ M WASEEM university of education LAHORE Pakistan i am from mailsi vehari and studied in lahore bsc in science college multan msc from lahore

1. CLEFT LIP
HAFIZ M WASEEM UNIVERSITY
OF EDUCATION LAHORE

2. CONTENTS
1. INTRODUCTION
2. TYPES
3. CHANGES IN PREGNANCY
4. CAUSES
5. FAMILY RELATIONS
6. HUMAN TERATOGENS
7. DIAGNOSIS
8. TREATMENT
9. CONCLUSION
10.REFERENCES

3. INTRODUCTION
Cleft: means fissure
FACIAL CLEFT: a fissure resulting from
incomplete merging or fusion of embryonic
processes normally uniting in the formation of face
There is an excess of males with cleft lip 2:1
Female excess has been reported in isolated cleft
palate cases
25% - CLEFT LIP

4. INTRODUCTION
• A cleft lip is type of birth defect that affects the
upper lip.
• Cleft lip (cheiloschisis) is the most common
congenital malformation since prehistoric times.
• Occurs in a well-defined places, along definite
axis.

5. TYPES OF CLEFT LIP
Partial or incomplete cleft
It is formed in the top of lip as either a small gap or an indentation in the lip
Complete cleft
Or it continues into the nose
Unilateral or bilateral cleft
It is due to the failure of fusion of the maxillary prominence and medial nasal
processes (formation of the primary palate).

6. Changes in pregnany
• Neural crest cells play an important role in facial morphogenisis
• Just before neural fold fuse to form neural tube, neuro ectodermal
cells adjacent to neural plate migrate to facial region
• These cells form the skeletal and connective tissues of the facelike
bone, cartilages, fibrous tissue, dental tissue

7. Development of face is controlled by 2 organic
centres
Procencephalic organizer – induces the
formation of upper 3rd of the face
Rombencephalic organizer – forms the
middle and caudal 3rd of face

8. 4th week – stomedium (primitive oral cavity) is covered
by maxillary, mandibular and fronto nasal prominence

9. • 5th week – nasal placodes arise as thickning of either side of the
frontal prominence
• Horse shoe shaped ridge consisting of medial and nasal swelling
surrounds each nasal placodes
• As mesenchyme elevates the ridge the nasal pits are formed

10. 6th and 7th week
• Two mandibular prominence emerge in the midline
• The maxillary prominence fuse with medial nasal
prominence

11. CAUSES
• The exact cause of clefting is unknown
• Multifactorial
• Chemical exposure, radiations, maternal hypoxia,
teratogenic drugs, nutritional deficiencies, physical
obstruction, and genetic influences.

12. The syndromal were classified by pashayan in 1983 into:
1. Major mutant genes usually with a known mendelian
inheritance pattern such as Treacher-Collins, Stickler
or van der Woude syndrome.
2. Chromosomal abnormalies such as the trisomy (D,E,
and P)
3. Teratogenic syndromes secondry to drug and alcohol
ingestion as Fetal alcohol syndrome, Fetal
phenytoin syndrome, Fetal valproate syndrome

13. Family relation
Affected relatives predicted recurrence CL
1 sibling 4.4%
1 parent 3.2%
1 sibling, 1 parent 15.8%

14. HUMAN TERATOGENS CAUSING CLEFT
• Ethyl alcohol
• Diphenyl hydantoin
• Trimethadione
• Retinoids
• Methotrexate
• Hyperthermia
• Smoking

15. Diagnosis
• Prenatal ultrasound _ 2D or 3D
• Prenatal counseling
• 22% to 33% rates for detecting facial clefts
• 73% - fetal cleft lip
• Color doppler ultrasonography can also be used

16. TREATMENT
• Can be successfully treated with surgery
• Often done in the first few months of life
• Speech therapy and dental care may also be needed
• With appropriate treatment, outcomes are good

17. CONCLUSION
• The management of cleft lip is necessary at correct
time. If delayed in the treatment there may be
possibility to developed abnormalities.
• So to prevent some problems like speech problems,
facial asymmetry , feeding problem and infection to
nasal cavity and unasthetic appearance. The treatment
is necessary.

18. REFERENCES
1. Mai CT, Isenburg JL, Canfield MA, Meyer RE, Correa A, Alverson CJ,
Lupo PJ, Riehle‐Colarusso T, Cho SJ, Aggarwal D, Kirby RS. National
population‐based estimates for major birth defects, 2010–2014. Birth
Defects Research. 2019; 111(18): 1420-1435.
2. Little J, Cardy A, Munger RG. Tobacco smoking and oral clefts: a
meta-analysis. Bull World Health Organ. 2004;82:213-18.
3. https://www.mayoclinic.org/diseases-conditions/cleft-
palate/symptoms-causes/syc-20370985