cleft lip and palate

1. By
Dr SAQBA ALAM

2.  Abnormal gap
 Gap in lip = cleft lip
 Cleft in palate
 Combined/Isolated
 Others

3.  Study from Glasgow =1.56/1000 total birth
 1.5 times greater than whites
 Three fourth= [lf] unilateral, One fourth
bilateral.
 left –right-bilateral =6:3:1
 Ratio of cleft lip and palate :cleft lip =2:1
 Most common combined= cleft palate
(primay/sec palate or both)+ cleft lip=45%
 Isolated cleft lip =30%
 Isolated cleft palate = 25%

4.  Most common congenital defect
 Considerable racial variation
 Combined > males
 Isolated CP > females
 Isolated cleft lip = almost equal


5.  OVERALL INCIDENCE =1 IN 1000
 WHITES = 1IN 750
 ASIANS =1 IN 500
 BLOOD SUPPLY- LABIAL ARTERY BILATERALLY
 NS=SENSORY v2
 MOTOR vii (zygo-
matic+buccal branch

6.  Upper lip = fusion btw paired medial nasal
and max prominences
 Lower lip =fusion btw rt and lf mandibular
prominences
 Philtrum = fused paired medial nasal
prominences.

9.  The primary palate is formed by two parts:
maxillary components of the first pharyngeal
arch (lateral) and frontonasal prominence
(midline)
The secondary palate can also be divided in
two anatomical parts:
Anterior hard palate - ossified (contributions
from the maxilla and palatine bones).
 posterior soft palate - muscular.

12.  Multidisciplinary approach
 Intra uterine anomoly confirmation and
psychological parent prep
 Option to discontinue pregnancy
 AFTER BIRTH :-
 Special feeding guidelines and nursing care
 Special bottles
 obturators

15.  Cleft lip repair:
 Closed in layers,mucosa,muscle skin
 Millard's approach
 Tennyson Triangular approach
 Rectangular flap method
 Veau procedure for bilateral lip repair

17.  1-Von langenbeck ,2-V Y push back,3-
Schweekendiek