Cleft Lip And Cleft Palate Important Notes
- Rule Of 10 For Cleft Repair
- Weight should be 10 lbs
- Age – 10 weeks
- Haemoglobin – 10 gm%
- Surgeries Used For Cleft Lip Repair Are
- Millard’s rotation advancement flap surgery
- Tennison-Randall triangular flap method
- Surgeries For Cleft Palate Repair
- Ward Wills operation
- Y-V push-back palatoplasty
Cleft lip and palate question and answers
Cleft Lip And Cleft Palate Long Essays
Question 1. Classification of cleft lip and cleft palate and writing about their effects on eating and teeth
Answer:
Cleft Lip And Cleft Palate Classification:
- Venn’s Classification
- Grade 1- cleft of soft palate only
- Grade 2- cleft of the hard and soft palate to the incisive foramen
- Grade 3- complete unilateral cleft of the soft and hard palate and the lips and alveolus
- Grade 4- complete bilateral cleft of the soft and hard palate and the lips and alveolus
- Davis And Ritchie’s Classification
- Grade 1 – alveolar cleft
- Grade 2- post alveolar cleft
- Grade 3- alveolar cleft
- Kernahan And Stark’s Classification
- Cleft of primary palate only
- Cleft of primary and secondary palate
- Cleft of secondary palate only
Cleft Lip And Cleft Palate Effects On Eating:
- Difficulty in feeding
- Difficulty in suckling on the nipple to get enough milk due to
- Intake of too much air while feeding
- Milk coming out through the nose
- For this feeding the baby in different positions and angles is recommended
Cleft Lip And Cleft Palate Effects On Teeth:
- The first teeth may be missing
- If present it may come out
- Overcrowding of teeth
- Overgrowth of the maxilla occurs compared to the mandible
- Needs orthodontic treatment
- Removal of some teeth is done
Read And Learn More: General Surgery Question and Answers
Question 2. Describe the congenital anomalies of the faciomaxillary region and describe the management of cleft palate
Answer:
Congenital Anomalies:
- Classification
- Congenital
- Harelip- causes
- Nonfusion of maxillary processes and medial nasal process
- Defective development of the frontonasal process
- Non fusion of two mandibular process
- Oblique facial cleft
- Arise due to confusion of the maxillary and lateral nasal process
- Macrostomia
- Due to inadequate fusion of maxillary and Mandibular process
- Microstomia
- Due to too much fusion
- Bifid nose
- Due to bifurcation of frontonasal process
- Mandibulofacial dysostosis
- Retrognathia or agnathia
- Hypertelorism- widely separated eyes
Management Of Cleft Palate:
- Langenbeck’s operation
- Margins of the cleft are pared, the nasal septum is defined and separated off the upper surface of the cleft palate
- Mucoperiosteal flaps are lifted from the hard palate
- Two release incisions are made on each side just medial to the alveolar margins
- Mucoperiosteal flaps are mobilized
- The cleft is then repaired
Question 3. Describe the etiology, pathogenesis, clinical features, and management of cleft lip.
Answer:
Cleft Lip
A cleft lip is a congenital anomaly caused due to abnormal facial development during gestation
Cleft Lip Etiology:
- Hereditary
- Increased parental age
- Associated with other syndromes like Pierre Robin’s syndrome, ectodermal dysplasia
- Environmental factors
- Nutritional deficiency
- Radiation exposure
- Steroids injections
- Hypoxia
- Aspirin and other teratogenic drugs
Cleft Lip Pathogenesis:
- Various Theories Are Put forward, they are
- Asynchronous development of various processes leading to fusion between them
- Failure of mesodermal development to form connective tissue bands across lines of fusion
- Interruption in the migration of the neural crest cells from the neural plate
Cleft Lip Clinical Features:
- Upper lip cleft is occasionally associated with the presence of two small blind tubes in the lower lip
- Lower lip cleft is rare
- Patient looks ugly
- Difficulty in suckling
- Teeth may come out through the gap
- Defective speech
- Deformed nostrils
Cleft Lip Management:
- Mirault- Blair operation- it is carried out in three stages
- Stage 1
- Adequate mobilization of the lip lateral to the cleft, the ala of the affected nostril, and a considerable part of the cheek is performed the lip is everted
- The incision is made in a groove between the lip and the maxilla
- Bleeding is checked by firm pressure
- Stage 2
- An ink mark is made on the lip
- The margins are made of raw
- Stage 3
- Skin flaps are sutured
- A rubber tube is introduced through the nostril
- The mucous membrane and the muscles are sutured separately with chromic catgut
- Finally, the skin is sutured
Cleft palate viva questions with answers
Question 4. Describe the etiology, pathogenesis, clinical features, and management of cleft palate.
Answer:
Cleft Palate
- It is a congenital disorder
- It involves a breach in the continuity of the palate formed during the development of the face
- Corrected entirely surgically
Cleft Palate Etiology:
- Hereditary
- Sex
- Maternal age
- Syndrome associated
- Environmental factors
Cleft Palate Pathogenesis:
- Various Theories Are Put Forward, They Are
- Asynchronous development of various processes leading to fusion between them
- Failure of mesodermal development to form connective tissue bands across lines of fusion
- Interruption in the migration of the neural crest cells from the neural plate
Cleft Palate Clinical Features:
- Facial deformity
- Inability to feed
- Defective speech
- Nasal regurgitation of fluids
- Difficulty in hearing
- Defect in smelling
- Repeated respiratory tract infection
- There may be chances of aspiration pneumonia
- Dental Problems
- Malformed teeth
- Malocclusion
- Congenital anomalies
Timing of Repair: 12-24 Months
Management Protocol Of Cleft Patients:
- Immediately after birth
- Pediatric consultation
- First few weeks
- Hearing testing
- t10-12 weeks
- Surgical repair of lip
- Before 1 year or I8 months
- Surgical repair of palate
- 3 months after palate repair
- Speech and language repair
- 3-6 years
- Soft palate lengthening
- 5-6 years
- Pharyngeal surgery
- At 7 years
- Orthodontic treatment phase 1
- 9-11 years
- Pre-alveolar bone grafting
- 12 years or later
- Full orthodontic treatment phase 2
- 15-18 years
- Placement of implant
- 18-21 years
- Surgical advancement
- Final nose and lip revision
- Rhinoplasty
Cleft lip dental questions and answers
Cleft Lip And Cleft Palate Short Essays
Question 1. Cleft Lip
Answer:
Cleft Lip
A cleft lip is a congenital anomaly caused due to abnormal facial development during gestation
Cleft Lip Etiology:
- Hereditary
- Increased parental age
- Associated with other syndromes like Pierre Robin’s syndrome, ectodermal dysplasia
- Environmental factors
- Nutritional deficiency
- Radiation exposure
- Steroids injections
- Hypoxia
- Aspirin and other teratogenic drugs
Cleft lip Clinical Features:
- Upper lip cleft is occasionally associated with the presence of two small blind tubes in the lower lip
- Lower lip cleft is rare
- Patient looks ugly
- Difficulty in suckling
- Teeth may come out through the gap
- Defective speech
- Deformed nostrils
Cleft Lip Management:
- Mirault- Blair operation- it is carried out in three stages
- Stage 1
- Adequate mobilization of the lip lateral to the cleft, the ala of the affected nostril, and a considerable part of the cheek is performed the lip is everted
- The incision is made in a groove between the lip and the maxilla
- Bleeding is checked by firm pressure
- Stage 2
- An ink mark is made on the lip
- The margins are made of raw
- Stage 3
- Skin flaps are sutured
- A rubber tube is introduced through the nostril
- The mucous membrane and the muscles are sutured separately with chromic catgut
- Finally, the skin is sutured
Question 2. Cleft Palate
Answer:
Cleft Palate
- It is a congenital disorder
- It involves a breach in the continuity of the palate formed during the development of the face
- Corrected entirely surgically
Cleft Palate Etiology:
- Hereditary
- Sex
- Maternal age
- Syndrome associated
- Environmental factors
Cleft Palate Clinical Features:
- Facial deformity
- Inability to feed
- Defective speech
- Nasal regurgitation of fluids
- Otological problems
- Dental problems
- Malformed teeth
- Malocclusion
- Congenital anomalies
Cleft lip and palate short notes questions
Question 3. Development of face
Answer:
Development Of Face
- Around 4th week of intrauterine life, a prominent bulge develops on the ventral aspect of the embryo.
- Below it, there is a depression called stomadeum.
- The mesoderm covering the developing forebrain proliferates and forms a downward projection called the frontonasal process.
- The pharyngeal arches are laid down.
- The first branchial arch helps in the development of nasomaxillary complex.
- It forms the lateral border of the stomodeum.
- It gives off a bud from its dorsal end called nasal placodes.
- These placodes soon shrink to form nasal pits.
- At this stage, the stomodeum is surrounded
- Above- frontonasal process
- Sides- maxillary process
- Below- Mandibular process
- The resultant nasal pit divides into the medial nasal process and lateral nasal process
- The maxillary process lust with the lateral nasal process and forms a nasolacrimal duet
- Lower Lip
- The Mandibular processes of the two sides grow towards each other and fuse in the midline to form lower lip ami lower jaw
- Upper Lip
- Formed by the two media nasal prominence and the two maxillary prominences
- Nose
- The maxillary process fuses with the medial nasal process, as a result, nasal pits are cut off from the stadium
- The frontonasal process becomes narrower to form nasal septum
- Cheeks
- Formed by the fusion of maxillary and Mandibular process
Question 4. Hare Lip
Answer:
Hare Lip It is used to describe defects of the lip
Hare Lip Causes:
- Nonfusion of maxillary processes with the medial nasal process- leads to a defect in the upper lip
- Defective development of frontonasal process- leads to midline defect of the upper lip
- Nonfusion of two mandibular processes- leads to midline defect of the lower lip
Oral surgery cleft lip and palate questions
Cleft Lip And Cleft Palate Viva Voce
- A cleft lip is formed due to disturbance during 6 weeks of IU life
- A cleft palate is formed due to disturbances during 8 weeks of IU life
- A cleft lip is formed due to a defect in the fusion of the medial nasal process with the maxillary process
- A cleft palate is formed due to defective fusion of the premaxilla and two palatine processes
- Cleft lip repair begins at 3-6 months of age
- Cleft palate repair begins at 6-8 months of age