Diagnosis? Complication? Management? Station 1 Diagnosis? Complication? Management?

Cleft deformity Unilateral cleft lip Bilateral cleft lip Cleft palate

diagnosis? the diagnosis is made at the time of birth by physical examination. On PEx.: Describe what you see cleft lip: Site (Rt. Or Lt.) /uni lat. Or bi lat. Complete or incomplete . If it reaches the nostril & associated with nasal deformity (complete cleft lip). Open the mouth to examine the palate & to see is it cleft lip only or cleft lip & palate. Cleft lip is due to the failure of fusion of the maxillary and medial nasal processes.

Cleft palate: Submucous cleft palate : Isolated cleft palate or cleft lip & palate. Site : uni lat. Or bi lat. Complete or incomplete /soft palate or both soft & hard palate. Submucous cleft palate : is the triad of bifid uvula, notching of the hard palate, and muscular diastasis of the soft palate. Cleft palate occurs due to the failure of fusion of the lateral palatine processes, the nasal septum, and/or the median palatine processes

Complication? Feeding problems: due to inadequate suction, difficulty in swallowing & nasal regurgitation. difficulty in Speech : esp. with م ، ب which is lip sounds & س ، د which is palate sounds. middle ear infections : due to Eustachian tube dysfunction and/or nasal regurgitation. Recurrent respiratory tract infections & aspiration pneumonia. Cosmetic appearance & they are more likely to have social, emotional and behavioral problems. Nasal deformity. tooth development likely to be affected eg: crowded teeth.

Management : Is cleft repair which is faced with timing so that hearing and speech are optimized & effects on midface growth are minimized. Cleft lip repair is usually planned according to the role of 10 . at approximately ten weeks of age, When the baby weighs ten pounds, RBC 10,000 , and the hemoglobin is ten grams. Cleft palate repair is usually scheduled at 1 year of age to wait for face development & not later to avoid speech problems. 1ry rhinoplasty : at age of 3 m Alveolar defect repair : at 12 years of age with completion of permanent teeth .