What is a cleft
-an abnormal opening (fissure) in an anatomical structure that is typically closed
If there is a failure of parts to fuse at midline what is it called
a cleft
What is present if all structures are present but not fused or developed normally
a cleft
what are causes of a cleft
- embryologic under development
- chromosomal disorders
- genetic disorders
- maternal factors
- environmental teratogens
what are examples of embryologic under development
cell migration delay and cell disruption
what are examples of maternal factors that can cause a cleft
- older age
- utero factors
- maternal malnutrition
what are examples of environmental teratogens that can cause a cleft
- cigarette smoke
- dilantin
- thalidomide
- valium
- lead
- corticosteroids
What are the different classification of clefts
- normal
- complete
- incomplete
- unilateral
- bilateral
- soft palate cleft
- hard palate cleft
- complete palate cleft
- bilateral palate cleft
What does a cleft of the primary palate include
lip and alveolus
what are the different types of primary palate clefts
- complete (thru to incisive foramen) or incomplete (lip only)
- unilateral or bilateral
what does a cleft of the secondary palate include
hard palate and velum
what are the different types of secondary palate clefts
- complete (uvula to incisive foramen) or incomplete (bifid uvula into velum)
- with or without cleft lip
What are the types of sub mucous cleft palates
Overt and occult
describe the overt sub mucous cleft palate
- Identified thru intraoral exam
- bifid uvula
- zona pellucida (blush area in middle of velum; V at rest)
- posterior hard palate notch
describe the occult sub mucous cleft palate
- hidden on nasal surface
- via nasoendoscopy
what are the different types of facial clefts
- oblique
- midline (median)
describe oblique facial clefts
- unilateral or bilateral
- affects skeletal and soft tissue
- begins at mouth> lateral, horizontal, upward (extreme disfigurement)
describe midline facial clefts
- mild
- causes cranial base anomalies
- associated with other midline anomalies
what are examples that cause cranial base anomalies in midline facial clefts
- encephalocele
- absent corpus callosum
what are examples that are associated with other midline anomalies in midline facial clefts
- bifid nose
- frontonasal dysplasia
- hypertelorism
- holoprosencephaly
