The document describes cleft lip and palate in a newborn patient. There are three types of cleft lip and three types of cleft palate. Treatment includes specialized feeding methods, hearing tests, and surgical repair of the cleft lip at 3 months and palate at 6 months. Cleft lip and palate can cause feeding difficulties, ear infections, speech problems, and other issues if not treated properly. The document provides details on the causes, incidence, signs, and potential complications of cleft lip and palate.

1. Dr. Maria Sheraz Khan

2. Case Scenario
 A newborn baby girl presented to you with cleft
lip and palate. Her parents are worried about
appearance and consequences of the disease.
a) what are the types of cleft lip and cleft palate?
b) How will you treat the child?

4. 1- UNILATERAL INCOMPLETE

5. 2- UNILATREAL
COMPLETE

6. 3- BILATERAL COMPLETE

8. 1- INCOMPLETE CLEFT
PALATE

9. 2- UNILATERAL COMPLETE
CLEFT LIP AND PALATE

10. 3- BILATERAL COMPLETE
CLEFT LIP AND PALATE

11. TREATMENT
 Feeding by using a soft and long teat with
an enlarged hole, tube feeding in erect
position, or breast-feeding in prone
position.

12.  A newborn hearing screening test , then
audiometery.
 The usual practice is to repair the cleft lip
at 3 months of age and the palate at 6
months or later. Too early a repair may
interfere with mild-facial growth
 Speech therapy.

14. CLEFT LIP/Palate
Cleft of the lip due to hypoplasia of
the mesenchymal layer, resulting in
failure of the medial nasal and
maxillary processes to join.
 Cleft of the palate is due to failure
of the palate shelves to
approximate or fuse.

15. INCIDENCE
Cleft lip with or without cleft palate is
about 1:750 births.
Isolated cleft palate is seen in 1:2500
births.
Cleft lip with or without cleft palate is
twice as common in boys.
Isolated cleft palate is seen more
frequently in girls.

16. ETIOLOGY
Possible etiologies are:
1. Maternal drug exposure.
2. Syndrome-malformation complex.
3. Isolated unknown
4. Genetic

17. Genetic factors are more important in
cleft lip with or without cleft palate
than in cleft palate alone.
Incidence of associated congenital
malformations and of impairment in
development is increased in children
with cleft defects, especially in those
with cleft palate alone.

18. CLINICAL
MANIFESTATIONS
 Cleft lip may vary from a small notch to a
complete separation extending into the
floor of the nose.
 Deformed, supernumerary, or absent teeth
are associated.

19.  Isolated cleft palate occurs in the midline
and may involve only the uvula or may
extend into or through the soft and hard
palates to the incisive foramen.

21. RECURRENCE RISK

22. COMPLICATIONS
 Feeding difficulties.
 Recurrent serous otitis media.
 Hearing and language delay.
 Speech problem, hypernasality, articulation
errors.

23. COMPLICATIONS
 Dental and orthodontic complications.
 Cosmetic appearance.
 Physiologic problem.

24. Pierre Robin sequence
 A form of cleft palate associated with
micrognathia (hypoplastic mandible) and
projection of tongue posteriorly during
development, preventing closure of the
palate, is called Pierre Robin sequence.

25. ASSOCIATED ANOMALIES
 Cardiovascular
 Renal
 Central nervous
 G.I.T
Particularly when part of a chromosomal
syndrome.

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