pediatric lecture on cleft lip and palate

1. CLEFT LIP AND PALATE

2. Affected about 1 per 700 babies
More common in male
Etiology –
Strong genetic component
Maternal drug exposure ( Phenytoin , Valporic,
Thalidomide)
Maternal Alcohol and tobacco use

3. Includes ,
Cleft lip (CL)
Cleft palate (CP)
Both together (CLP)

4. Cleft lip,
Appears resulting in a failure of the medial nasal
and maxillary process to join .
( Opening and extend upper lip in to the nose )

6. Cleft palate,
This occurs due to incomplete joining of hard
palate .Soft palate also can be cleft .
In most cases ,cleft lip is also present .
(Roof of the mouth contains an opening in to
nose)

8. Surgical repair of the lip may be performed
within the first week of life for cosmetic
reason.
The Palate is usually repaired at several month
of age

9. Complications
Difficulty in feeding- can occurs due to entering
milk to nose and also cause coughing and
choking.
But some affected infants can still be breast
fed successfully.
An infant with a cleft palate will have greater
success feeding in a more upright position
Gravity will help prevent milk from coming
through the baby’s nose

10. Management includes squeeze-bottle
feedings, special nipples, nipples with
attached shields to seal the palate, and
gastrostomy in severe cases.

11. Secretory otitis media – which may eventually
leads to hearing loss .
Hearing is related to learning to speak ,Babies
with palatal clefts may have compromised
hearing and therefore, if the baby can not
hear it cannot try to mimic the sounds of
speech.

12. Because of the gap ,air leaks into the nasal
cavity resulting in a hypernasal voice
resonance and nasal emissions while talking .
Usually need the aid of speech therapist

13. Pierre Robin Syndrome
Association with
• Micrognathia (Jaw is undersized)
• Posterior displacement of the
tongue (glossoptosis)
• Midline cleft of the soft palate.

14. There may be difficulty feeding and, as the
tongue falls back.
There is obstruction to the upper airways which
may result in cyanotic episodes.
The infant is at risk of failure to thrive during the
first few months.
Persistent obstruction can be treated using a
nasopharyngeal airway.
Eventually the mandible grows and these
problems resolve. The cleft palate can then be
repaired.