Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- fenda labial bilateral ± palatina
- fenda labial unilateral ± palatina
- fenda palatina isolada
- microforma de fenda labial
- fenda palatina submucosa isolada
- ultrassonografia pré-natal positiva
Other diagnostic factors
- dificuldade para se alimentar
- baixo ganho de peso
- obstrução das vias aéreas
Risk factors
- predisposição genética
- medicamentos anticonvulsivantes
- tabagismo materno
- consumo materno de bebidas alcoólicas
- deficiência de ácido fólico
Diagnostic tests
1st tests to order
- audiograma
- consulta genética
Tests to consider
- exame de resposta auditiva evocada do tronco encefálico (BERA)
- raio-x da coluna vertebral
- ultrassonografia renal
- hibridização in situ fluorescente (FISH)
- exame oftalmológico
Treatment algorithm
fenda labial e fenda palatina completas
fenda palatina isolada
fenda labial isolada
Contributors
Authors
Travis T. Tollefson, MD, MPH, FACS
Professor and Director
Facial Plastic and Reconstructive Surgery
Otolaryngology - Head and Neck Surgery
Cleft and Craniofacial Team
University of California Davis
Sacramento
CA
Disclosures
TTT has received an honorarium and reimbursement for travel by the AO Foundation for teaching on a facial trauma course. TTT serves on the American Board of Otolaryngology and the American Board of Facial Plastic and Reconstructive Surgery, and receives a royalty from Thieme publishing for the textbook Complete Cleft Care. TTT is an author of studies referenced in this topic. TTT serves as editor-in-chief of the journal ‘Facial Plastic Surgery and Aesthetic Medicine’.
David A. Shaye, MD
Instructor
Facial Plastic and Reconstructive Surgery
Massachusetts Eye and Ear
Harvard University
Boston
MA
Disclosures
DAS has received an honorarium and reimbursement for travel by the AO Foundation for teaching on a facial trauma course.
Peer reviewers
Jordan N. Halsey, MD
Pediatric Plastic and Craniofacial Surgeon
Assistant Professor of Plastic Surgery
Johns Hopkins University
Assistant Professor of Plastic Surgery
University of South Florida
Tampa
FL
Disclosures
JNH declares that he has no competing interests.
References
Key articles
Veau V. Bec-de-lièvre; formes cliniques - chirurgie. Avec la collaboration de J Récamier. Paris, France: Masson et Cie; 1938.
Wyszynski DF, Beaty TH, Maestri NE. Genetics of nonsyndromic oral clefts revisited. Cleft Palate Craniofac J. 1996 Sep;33(5):406-17.Full text Abstract
Royal College of Paediatrics and Child Health. Palate examination: identification of cleft palate in the newborn. Oct 2014 [internet publication].Full text
American Cleft Palate-Craniofacial Association. Parameters for evaluation and treatment of patients with cleft lip/palate or other craniofacial differences. Jan 2018 [internet publication].Full text
Boyce JO, Reilly S, Skeat J, et al. ABM Clinical Protocol #17: Guidelines for breastfeeding infants with cleft lip, cleft palate, or cleft lip and palate-revised 2019. Breastfeed Med. 2019 Sep;14(7):437-44.Full text Abstract
Cutting C, Grayson B, Brecht L, et al. Presurgical columellar elongation and primary retrograde nasal reconstruction in one-stage bilateral cleft lip and nose repair. Plast Reconstr Surg. 2012 Sep;130(3):659-66. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Guidelines
- Parameters for evaluation and treatment of patients with cleft lip/palate or other craniofacial differences
- Palate examination: identification of cleft palate in the newborn
More Guidelines
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