Cleft lip and cleft palate: Difference between revisions
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{{Infobox medical condition | |||
| name = Cleft lip and cleft palate | |||
| image = [[File:Cleftlipandpalate.JPG|250px]] | |||
| caption = A child with a cleft lip and palate | |||
| field = [[Oral and maxillofacial surgery]], [[Pediatrics]], [[Genetics]] | |||
| synonyms = [[Cheiloschisis]] (cleft lip), [[Palatoschisis]] (cleft palate) | |||
| symptoms = [[Facial deformity]], [[Feeding difficulties]], [[Speech problems]], [[Ear infections]] | |||
| complications = [[Hearing loss]], [[Dental problems]], [[Psychosocial issues]] | |||
| onset = [[Congenital disorder|Congenital]] | |||
| duration = [[Lifelong]] | |||
| causes = [[Genetic factors]], [[Environmental factors]] | |||
| risks = [[Family history]], [[Maternal smoking]], [[Diabetes]], [[Obesity]] | |||
| diagnosis = [[Physical examination]], [[Prenatal ultrasound]] | |||
| differential = [[Pierre Robin sequence]], [[Van der Woude syndrome]] | |||
| prevention = [[Prenatal care]], [[Folic acid supplementation]] | |||
| treatment = [[Surgery]], [[Speech therapy]], [[Orthodontics]] | |||
| medication = [[Pain management]], [[Antibiotics]] | |||
| prognosis = [[Good with treatment]] | |||
| frequency = 1 in 700 births | |||
| deaths = Rare | |||
}} | |||
[[Cleft lip]] and [[cleft palate]], collectively termed as [[orofacial clefts]], are congenital deformities that occur when the tissues of the lip and/or the palate of the fetus do not fuse properly during the first trimester of pregnancy. A cleft lip involves a split in the upper lip, which can extend into the nose and can occur on one or both sides or in the middle. A cleft palate is characterized by an opening in the roof of the mouth that can extend into the nasal cavity.<ref>{{cite book |last= Marazita |first= ML |title= The Evolution of Human Genetic Studies of Cleft Lip and Cleft Palate |journal= Annual Review of Genomics and Human Genetics |year= 2012 |volume= 13 |pages= 263–283 |doi=10.1146/annurev-genom-090711-163729}}</ref> | [[Cleft lip]] and [[cleft palate]], collectively termed as [[orofacial clefts]], are congenital deformities that occur when the tissues of the lip and/or the palate of the fetus do not fuse properly during the first trimester of pregnancy. A cleft lip involves a split in the upper lip, which can extend into the nose and can occur on one or both sides or in the middle. A cleft palate is characterized by an opening in the roof of the mouth that can extend into the nasal cavity.<ref>{{cite book |last= Marazita |first= ML |title= The Evolution of Human Genetic Studies of Cleft Lip and Cleft Palate |journal= Annual Review of Genomics and Human Genetics |year= 2012 |volume= 13 |pages= 263–283 |doi=10.1146/annurev-genom-090711-163729}}</ref> | ||
[[File:Cleftlipandpalate.JPG|thumb|Cleftlipandpalate]] | [[File:Cleftlipandpalate.JPG|left|thumb|Cleftlipandpalate]] | ||
==Etiology== | ==Etiology== | ||
The exact cause of cleft lip and cleft palate is not known, but both genetic and environmental factors appear to play a role. Family history, maternal smoking, use of certain medications during pregnancy, and nutritional deficiencies have all been associated with an increased risk of these conditions.<ref>{{cite journal |last= Mossey |first= P |title= Global strategies to reduce the healthcare burden of craniofacial anomalies |journal= British Dental Journal |year= 2003 |volume= 195 |issue= 8 |pages= 613–620 |doi=10.1038/sj.bdj.4810677}}</ref> | The exact cause of cleft lip and cleft palate is not known, but both genetic and environmental factors appear to play a role. Family history, maternal smoking, use of certain medications during pregnancy, and nutritional deficiencies have all been associated with an increased risk of these conditions.<ref>{{cite journal |last= Mossey |first= P |title= Global strategies to reduce the healthcare burden of craniofacial anomalies |journal= British Dental Journal |year= 2003 |volume= 195 |issue= 8 |pages= 613–620 |doi=10.1038/sj.bdj.4810677}}</ref> | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
The physical characteristics of cleft lip and cleft palate are often recognizable at birth. These include a split in the lip and/or an opening in the roof of the mouth. These defects can result in difficulties with feeding, speech problems, hearing impairment, and recurrent ear infections. Psychological and social issues may also arise due to differences in facial appearance.<ref>{{cite book |last= American Academy of Pediatrics |first= Section on Pediatric Dentistry |title= Oral Health Risk Assessment Timing and Establishment of the Dental Home |journal= Pediatrics |year= 2003 |volume= 111 |issue= 5 |pages= 1113–1116 |doi=10.1542/peds.111.5.1113}}</ref> | The physical characteristics of cleft lip and cleft palate are often recognizable at birth. These include a split in the lip and/or an opening in the roof of the mouth. These defects can result in difficulties with feeding, speech problems, hearing impairment, and recurrent ear infections. Psychological and social issues may also arise due to differences in facial appearance.<ref>{{cite book |last= American Academy of Pediatrics |first= Section on Pediatric Dentistry |title= Oral Health Risk Assessment Timing and Establishment of the Dental Home |journal= Pediatrics |year= 2003 |volume= 111 |issue= 5 |pages= 1113–1116 |doi=10.1542/peds.111.5.1113}}</ref> | ||
==Diagnosis== | ==Diagnosis== | ||
The diagnosis of cleft lip and/or cleft palate is usually made at birth through physical examination. In some cases, prenatal ultrasound can detect these conditions in the fetus. After birth, further tests may be conducted to assess the extent of the condition and its impact on the child's health.<ref>{{cite book |last= Weatherley-White |first= RCA |title= Detection of fetal cleft lip and jaw on routine ultrasound examination |journal= American Journal of Obstetrics and Gynecology |year= 1986 |volume= 155 |issue= 3 |pages= 526–529 |doi=10.1016/0002-9378(86)90343-2}}</ref> | The diagnosis of cleft lip and/or cleft palate is usually made at birth through physical examination. In some cases, prenatal ultrasound can detect these conditions in the fetus. After birth, further tests may be conducted to assess the extent of the condition and its impact on the child's health.<ref>{{cite book |last= Weatherley-White |first= RCA |title= Detection of fetal cleft lip and jaw on routine ultrasound examination |journal= American Journal of Obstetrics and Gynecology |year= 1986 |volume= 155 |issue= 3 |pages= 526–529 |doi=10.1016/0002-9378(86)90343-2}}</ref> | ||
==Treatment== | ==Treatment== | ||
Treatment for cleft lip and cleft palate often involves a multidisciplinary team of professionals, including plastic surgeons, dental specialists, speech therapists, audiologists, and psychologists. The primary treatment is surgical repair, which is typically carried out within the first few months of life for a cleft lip and before the child's second birthday for a cleft palate.<ref>{{cite book |last= American Cleft Palate-Craniofacial Association |title= Parameters for Evaluation and Treatment of Patients with Cleft Lip/Palate or Other Craniofacial Anomalies |year= 1993 |publisher= American Cleft Palate-Craniofacial Association}}</ref> Additional surgeries may be required later in life to improve speech or appearance. | Treatment for cleft lip and cleft palate often involves a multidisciplinary team of professionals, including plastic surgeons, dental specialists, speech therapists, audiologists, and psychologists. The primary treatment is surgical repair, which is typically carried out within the first few months of life for a cleft lip and before the child's second birthday for a cleft palate.<ref>{{cite book |last= American Cleft Palate-Craniofacial Association |title= Parameters for Evaluation and Treatment of Patients with Cleft Lip/Palate or Other Craniofacial Anomalies |year= 1993 |publisher= American Cleft Palate-Craniofacial Association}}</ref> Additional surgeries may be required later in life to improve speech or appearance. | ||
==Feeding Management== | ==Feeding Management== | ||
Babies with cleft lip and/or cleft palate often have difficulty feeding due to the opening between the mouth and the nasal cavity. Special feeding techniques and devices, such as squeezable bottles and specially designed nipples, can help ensure that the child receives adequate nutrition.<ref>{{cite book |last= Reid |first= J |title= A Review of Feeding Interventions for Infants With Cleft Palate |journal= Cleft Palate-Craniofacial Journal |year= 2011 |volume= 48 |issue= 5 |pages= 567–576 |doi=10.1597/09-113}}</ref> | Babies with cleft lip and/or cleft palate often have difficulty feeding due to the opening between the mouth and the nasal cavity. Special feeding techniques and devices, such as squeezable bottles and specially designed nipples, can help ensure that the child receives adequate nutrition.<ref>{{cite book |last= Reid |first= J |title= A Review of Feeding Interventions for Infants With Cleft Palate |journal= Cleft Palate-Craniofacial Journal |year= 2011 |volume= 48 |issue= 5 |pages= 567–576 |doi=10.1597/09-113}}</ref> | ||
==Speech Therapy== | ==Speech Therapy== | ||
Because of the structural abnormalities in the mouth and palate, children with cleft lip and/or cleft palate often have speech difficulties. Speech therapy is usually necessary to assist with language development and articulation.<ref>{{cite book |last= Chapman |first= KL |title= Speech and language development in infants with cleft palate |journal= The Cleft Palate-Craniofacial Journal |year= 2011 |volume= 48 |issue= 2 |pages= 173–183 |doi=10.1597/09-115}}</ref> | Because of the structural abnormalities in the mouth and palate, children with cleft lip and/or cleft palate often have speech difficulties. Speech therapy is usually necessary to assist with language development and articulation.<ref>{{cite book |last= Chapman |first= KL |title= Speech and language development in infants with cleft palate |journal= The Cleft Palate-Craniofacial Journal |year= 2011 |volume= 48 |issue= 2 |pages= 173–183 |doi=10.1597/09-115}}</ref> | ||
==Hearing Management== | ==Hearing Management== | ||
Children with cleft palate are at increased risk of [[otitis media]], a middle ear infection, which can lead to hearing loss. Regular hearing evaluations and appropriate interventions, such as the placement of ear tubes, may be necessary.<ref>{{cite journal |last=Paradise |first= JL |title=Otitis Media and Tympanostomy Tube Insertions Among Children With Cleft Palate |journal=Archives of Otolaryngology–Head & Neck Surgery |year=2000 |volume= 126 |issue= 5 |pages= 630–634 |doi=10.1001/archotol.126.5.630}}</ref> | Children with cleft palate are at increased risk of [[otitis media]], a middle ear infection, which can lead to hearing loss. Regular hearing evaluations and appropriate interventions, such as the placement of ear tubes, may be necessary.<ref>{{cite journal |last=Paradise |first= JL |title=Otitis Media and Tympanostomy Tube Insertions Among Children With Cleft Palate |journal=Archives of Otolaryngology–Head & Neck Surgery |year=2000 |volume= 126 |issue= 5 |pages= 630–634 |doi=10.1001/archotol.126.5.630}}</ref> | ||
==Prognosis== | ==Prognosis== | ||
With appropriate management and care, most individuals with cleft lip and cleft palate lead a normal life. Early surgical intervention and supportive therapies can effectively manage the physical manifestations of the condition. Ongoing support and counseling may be needed to address potential self-esteem and psychological issues related to appearance and social acceptance.<ref>{{cite journal |last= Broder |first= HL |title= Psychological adjustment in 12-year-old children with orofacial clefts: A case–control study |journal= The Cleft Palate-Craniofacial Journal |year= 1998 |volume= 35 |issue= 6 |pages= 480–485 |doi=10.1597/1545-1569(1998)035<0480:PAIYCO>2.3.CO;2}}</ref> | With appropriate management and care, most individuals with cleft lip and cleft palate lead a normal life. Early surgical intervention and supportive therapies can effectively manage the physical manifestations of the condition. Ongoing support and counseling may be needed to address potential self-esteem and psychological issues related to appearance and social acceptance.<ref>{{cite journal |last= Broder |first= HL |title= Psychological adjustment in 12-year-old children with orofacial clefts: A case–control study |journal= The Cleft Palate-Craniofacial Journal |year= 1998 |volume= 35 |issue= 6 |pages= 480–485 |doi=10.1597/1545-1569(1998)035<0480:PAIYCO>2.3.CO;2}}</ref> | ||
==References== | ==References== | ||
<references /> | <references /> | ||
Latest revision as of 01:59, 5 April 2025
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| Cleft lip and cleft palate | |
|---|---|
| |
| Synonyms | Cheiloschisis (cleft lip), Palatoschisis (cleft palate) |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Facial deformity, Feeding difficulties, Speech problems, Ear infections |
| Complications | Hearing loss, Dental problems, Psychosocial issues |
| Onset | Congenital |
| Duration | Lifelong |
| Types | N/A |
| Causes | Genetic factors, Environmental factors |
| Risks | Family history, Maternal smoking, Diabetes, Obesity |
| Diagnosis | Physical examination, Prenatal ultrasound |
| Differential diagnosis | Pierre Robin sequence, Van der Woude syndrome |
| Prevention | Prenatal care, Folic acid supplementation |
| Treatment | Surgery, Speech therapy, Orthodontics |
| Medication | Pain management, Antibiotics |
| Prognosis | Good with treatment |
| Frequency | 1 in 700 births |
| Deaths | Rare |
Cleft lip and cleft palate, collectively termed as orofacial clefts, are congenital deformities that occur when the tissues of the lip and/or the palate of the fetus do not fuse properly during the first trimester of pregnancy. A cleft lip involves a split in the upper lip, which can extend into the nose and can occur on one or both sides or in the middle. A cleft palate is characterized by an opening in the roof of the mouth that can extend into the nasal cavity.<ref>ML,
The Evolution of Human Genetic Studies of Cleft Lip and Cleft Palate, 2012, Volume: 13, DOI: 10.1146/annurev-genom-090711-163729, Pages: 263–283,</ref>
Etiology[edit]
The exact cause of cleft lip and cleft palate is not known, but both genetic and environmental factors appear to play a role. Family history, maternal smoking, use of certain medications during pregnancy, and nutritional deficiencies have all been associated with an increased risk of these conditions.<ref>Mossey, P,
Global strategies to reduce the healthcare burden of craniofacial anomalies, British Dental Journal, 2003, Vol. 195(Issue: 8), pp. 613–620, DOI: 10.1038/sj.bdj.4810677,</ref>
Clinical Presentation[edit]
The physical characteristics of cleft lip and cleft palate are often recognizable at birth. These include a split in the lip and/or an opening in the roof of the mouth. These defects can result in difficulties with feeding, speech problems, hearing impairment, and recurrent ear infections. Psychological and social issues may also arise due to differences in facial appearance.<ref>Section on Pediatric Dentistry,
Oral Health Risk Assessment Timing and Establishment of the Dental Home, 2003, Volume: 111, DOI: 10.1542/peds.111.5.1113, Pages: 1113–1116,</ref>
Diagnosis[edit]
The diagnosis of cleft lip and/or cleft palate is usually made at birth through physical examination. In some cases, prenatal ultrasound can detect these conditions in the fetus. After birth, further tests may be conducted to assess the extent of the condition and its impact on the child's health.<ref>RCA,
Detection of fetal cleft lip and jaw on routine ultrasound examination, 1986, Volume: 155, DOI: 10.1016/0002-9378(86)90343-2, Pages: 526–529,</ref>
Treatment[edit]
Treatment for cleft lip and cleft palate often involves a multidisciplinary team of professionals, including plastic surgeons, dental specialists, speech therapists, audiologists, and psychologists. The primary treatment is surgical repair, which is typically carried out within the first few months of life for a cleft lip and before the child's second birthday for a cleft palate.<ref>,
Parameters for Evaluation and Treatment of Patients with Cleft Lip/Palate or Other Craniofacial Anomalies, American Cleft Palate-Craniofacial Association, 1993,</ref> Additional surgeries may be required later in life to improve speech or appearance.
Feeding Management[edit]
Babies with cleft lip and/or cleft palate often have difficulty feeding due to the opening between the mouth and the nasal cavity. Special feeding techniques and devices, such as squeezable bottles and specially designed nipples, can help ensure that the child receives adequate nutrition.<ref>J,
A Review of Feeding Interventions for Infants With Cleft Palate, 2011, Volume: 48, DOI: 10.1597/09-113, Pages: 567–576,</ref>
Speech Therapy[edit]
Because of the structural abnormalities in the mouth and palate, children with cleft lip and/or cleft palate often have speech difficulties. Speech therapy is usually necessary to assist with language development and articulation.<ref>KL,
Speech and language development in infants with cleft palate, 2011, Volume: 48, DOI: 10.1597/09-115, Pages: 173–183,</ref>
Hearing Management[edit]
Children with cleft palate are at increased risk of otitis media, a middle ear infection, which can lead to hearing loss. Regular hearing evaluations and appropriate interventions, such as the placement of ear tubes, may be necessary.<ref>Paradise, JL,
Otitis Media and Tympanostomy Tube Insertions Among Children With Cleft Palate, Archives of Otolaryngology–Head & Neck Surgery, 2000, Vol. 126(Issue: 5), pp. 630–634, DOI: 10.1001/archotol.126.5.630,</ref>
Prognosis[edit]
With appropriate management and care, most individuals with cleft lip and cleft palate lead a normal life. Early surgical intervention and supportive therapies can effectively manage the physical manifestations of the condition. Ongoing support and counseling may be needed to address potential self-esteem and psychological issues related to appearance and social acceptance.<ref>Broder, HL,
Psychological adjustment in 12-year-old children with orofacial clefts: A case–control study, The Cleft Palate-Craniofacial Journal, 1998, Vol. 35(Issue: 6), pp. 480–485, DOI: <0480:PAIYCO>2.3.CO;2 10.1597/1545-1569(1998)035<0480:PAIYCO>2.3.CO;2,</ref>
References[edit]
<references />
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| Congenital malformations and deformations of digestive system | ||||||||||||||
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| Cleft lip and cleft palate | ||||||
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| Genetic disorders relating to deficiencies of transcription factor or coregulators | ||||||||||||||||||||||||||||||||||
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| Cell membrane protein disorders (other than Cell surface receptor, enzymes, and cytoskeleton) | ||||||||||
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See also other cell membrane proteins
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