EMBRIOLOGY CLEFT ( smit and grap hal 185 )

A unilateral cleft lip res lts !r"m !ail re "! ! si"n "! the

medial nasal prominence and maxillary prominence on one side (Fig# $1#%&)# A bilateral cleft lip res lts !r"m !ail re "! ! si"n "! the merged medial nasal prominences 'ith the maxillary prominence on either side (Fig# $1#%B)# &s a res lt( the merged medial nasal pr"minen)es (gl"* lar pr")ess) are "!ten + ite pr"minent( as the, are n"t restrained *, atta)hment t" the ma-illar, pr"minen)es laterall,# This is mani!est at *irth( as in a patient 'ith a )"mplete *ilateral )le!t lip and anteri"r ".erpr"/e)ti"n "! the prema-illa and pr"la*i m# Laterall,( the ma-illar, and mandi* lar pr"minen)es /"in at the lateral )"mmiss re "! the m" th# Fail re "! ni"n "! these pr"minen)es pr"d )es ma)r"st"mia( as a res lt "! a )le!t "! the lateral )"mmiss re (Fig# $1#%F)# This is a n m*er 0 !a)ial )le!t *, the Tessier )lassi!i)ati"n (0)# &n"ther rare !a)ial )le!t is a median )le!t lip (Fig# $1#%1)( 'hi)h is )a sed *, in)"mplete merging "! the medial nasal pr"minen)es in the midline and is s all, ass")iated 'ith deep midline ! rr"'ing "! the n"se( res lting in .ari" s degrees "! nasal *i!idit,# This )"nditi"n is als" des)ri*ed as a n m*er 2 )le!t *, the Tessier )lassi!i)ati"n

(0)# Fail re "! the mandi* lar pr"minen)es t" nite in the midline pr"d )es a )entral de!e)t "! the l"'er lip and )hin (Fig# $1#%E)( 'hi)h is re!erred t" as a n m*er 32 )le!t *, the Tessier )lassi!i)ati"n (0)#