Chapter 51 Cleft Lip/Palate
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The prevalence of clefting varies between ___ per _____ births. The highest rates of clefting occurs in _______. Cleft lip occurs more frequently in _____, while cleft palate occurs more frequently in ________.
- 1 and 2
- Asians and Native Americans
What is a Class I Classification of Clefts
Cleft of the tip of the uvula
What is a Class II Classification of Clefts
Cleft of the uvula (bifid uvula).
What is a Class III Classification of Clefts
Cleft of the soft palate
What is a Class IV Classification of Clefts
Cleft of the soft and hard palates
What is a Class V Classification of Clefts
Cleft of the soft and hard palates that continues through the alveolar ridge on one side of the premaxilla; usually associated with cleft lip of the same side
What is a Class VI Classification of Clefts
Cleft of the soft and hard palates that continues through the alveolar ridge on both sides, leaving a free premaxilla; usually associated with bilateral cleft lip
What is a Class VII Classification of Clefts
Submucous cleft in which the muscle union is imperfect across the soft palate. The palate is short, the uvula is often bifid, a groove is situated at the midline of the soft palate, and the closure to the pharynx is incompetent
A cleft on one side of the lip that does not extend into the nose is called _______ which occurs due to ______
- unilateral incomplete
- lack of connective tissue migration between one maxillary process and medial nasal processes
Describe a Unilateral Complete Cleft Lip
Completely separates the lip and extends into the nose and mouth
Bilateral cleft lip occurs between ______
both maxillary processes and medial nasal processes
Cleft lip and palate represent a failure of normal fusion of embryonic processes during development in the _____ trimester of pregnancy
Formation of the lip occurs between the _______ week in utero. A cleft lip becomes apparent by the end of the ____ month
Development of the palate takes place during the ________ week. A cleft palate is evident by the end of the _____ month.
The nose, eyes, and mouth form between the ______ weeks.
4th and 6th
What are some risk factors for clefts
- Use of tobacco
- Alcohol consumption
- phenytoin, vitamin A (isotretinoin), corticosteroids, drugs of abuse
- Maternal age > 40 years
- Inadequate diet: vitamins, especially folic acid deficiency
Predisposition to ________ infections is common.
upper respiratory and middle ear
Ear infections are often due to a dysfunction of the ______ that connects the _______.
- Eustachian tube
- middle ear and the throat
Feeding difficulties occur more often with ______ than ______.
cleft palate than cleft lip
What are common missing teeth in clefts
- Maxillary lateral incisors.
- Maxillary premolar.
- Mandibular second premolars
Surgical union of the cleft lip is made at approximately _____ months of age.
Primary surgery to close the palate is usually undertaken by age ______ or earlier when possible
Bone grafting in the alveolar ridge is ideally done before
the eruption of the maxillary teeth
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