Cleft lip with or without cleft palate is approximately twice as common as isolated cleft palate.
The majority of cleft lip deformities are associated with a varying degree of nasal deformity.
Oro-facial clefts can occur in isolation or as a component of an identifiable syndrome. They are among the most common birth defects.
The aetiology of cleft lip and palate involves a variety of genetic and environmental factors that result in variable expressions of oro-facial clefting.
Comprehensive care involves a multi-disciplinary cleft team with specialists from fields such as facial plastic surgery, genetics, nursing, speech-language pathology, orthodontics, dentistry, oral surgery, audiology, and paediatrics.
An oro-facial cleft is an abnormal opening secondary to developmental failure in utero. Cleft lip with or without cleft palate can be unilateral or bilateral, and occurs in a variety of combinations with variable expression in the nose, lip, alveolus, and primary and secondary palates. Diminutive expressions of cleft lip and/or palate are known as microform, occult, minor, or forme fruste (aborted form).
History and exam
Key diagnostic factors
- presence of risk factors
- bilateral cleft lip ± palate
- unilateral cleft lip ± palate
- isolated cleft palate
- microform cleft lip
- isolated sub-mucous cleft palate
- positive antenatal ultrasound
Other diagnostic factors
- difficulty feeding
- poor weight gain
- airway obstruction
- genetic predisposition
- dysmorphic syndrome
- anticonvulsant drugs
- maternal tobacco use
- maternal alcohol consumption
- folic acid deficiency
1st investigations to order
Investigations to consider
- auditory brain stem response (ABR) test
- vertebral spine x-rays
- renal ultrasound
- fluorescence in situ hybridisation (FISH)
complete cleft lip and palate
isolated cleft palate
isolated cleft lip
- Parameters for evaluation and treatment of patients with cleft lip/palate or other craniofacial differences
- Palate examination: identification of cleft palate in the newborn
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