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.
Orofacial clefts can occur in isolation or as a component of an identifiable syndrome. They are among the most common birth defects.
The etiology of cleft lip and palate involves a variety of genetic and environmental factors that result in variable expressions of orofacial clefting.
Comprehensive care involves a multidisciplinary cleft team with specialists from fields such as facial plastic surgery, genetics, nursing, speech-language pathology, orthodontics, dentistry, oral surgery, audiology, and pediatrics.
An orofacial 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
- bilateral cleft lip ± palate
- unilateral cleft lip ± palate
- isolated cleft palate
- microform cleft lip
- isolated submucous cleft palate
- positive prenatal 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 hybridization (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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