Plastic Surgery Essentials for Students-Chapter 10: Cleft Lip and Palate

Chapter 10: Cleft Lip and Palate

Pdf Summary

The document outlines the anatomy, classification, demographics, genetics, and treatment of cleft lip and palate (CLP), a congenital condition affecting the facial structure. <br /><br /><strong>Anatomy and Definitions:</strong>  <br />Cleft Lip (CL) and Cleft Lip with Palate (CLP) are part of the same morphological spectrum, whereas Cleft Palate (CP) alone is a distinct entity. Clefts result from the failure of specific embryonic processes to fuse during gestation. CL occurs when there's a failure of medial nasal and maxillary processes to fuse. CP is split into primary and secondary; primary CP occurs when there's a failure of fusion before the incisive foramen, and secondary CP involves later fusions.<br /><br /><strong>Functional Deficits:</strong>  <br />Cleft conditions impair eating and speech. CL leads to difficulties in forming seals necessary for these functions, while CP causes air leakage during speech, complicating eating, and predisposes to ear infections.<br /><br /><strong>Classification:</strong>  <br />CL is categorized by its completeness and whether it is unilateral or bilateral. CP is classified as complete or incomplete, while CLP involves combinations of these attributes.<br /><br /><strong>Demographics and Genetics:</strong>  <br />The incidence of CLP shows ethnic variability, and it occurs more frequently in males. CP alone shows no ethnic variation but is more common in females. While most cases are sporadic and multifactorial, conditions like Van der Woude’s and DiGeorge syndromes can present genetic links.<br /><br /><strong>Treatment:</strong>  <br />Treatment is multidisciplinary, involving various specialists. Pre-operative techniques help align parts before surgery. Surgical intervention is staged: CL repair occurs at 2-3 months, CP repair at 9-15 months, with subsequent revisions and bone grafting as required. Orthognathic surgery and final aesthetic revisions occur typically during adolescence. <br /><br />Overall, the document emphasizes the complex nature of CLP conditions and the importance of coordinated care to address both functional and aesthetic needs systematically over time.

Keywords

cleft lip

cleft palate

congenital condition

anatomy

classification

genetics

treatment

demographics

functional deficits

multidisciplinary care