Keywords:

cleft palate, LIP, PROMINENCE, CPO, INCLUDE, Cleft lip, SYNDROME, PARENT,
DEVELOPMENT, nasal prominences

Digest:
...Continuing Education ActivityCleft palate is a developmental defect in the hard
palate that results in a communication between the oral and nasal cavities
resulting in nasal reflux during feeds....
...This activity reviews the evaluation and treatment of cleft palate and
highlights the role of the interprofessional team in managing patients with this
condition....
...Objectives:Identify the epidemiology of cleft palate....
...Explain the appropriate evaluation of cleft palate....
...Review the various management options available for cleft palate....
...Summarize the importance of collaboration among interprofessional team members
to improve care coordination for and long-term outcomes of patients with cleft
palate....
...It is characterized by failure of normal fusion of the palate and lip at the
midline during development resulting in a clinically obvious deformity of the
newborn....
...Cleft lip and palate (CL/P) and cleft palate alone (CPO) are not only cosmetic
deformities but have significant functional morbidity for the newborn without
adequate management....
...EtiologyCleft palate arises from a failure of development during gestation....
...The five facial prominences arise around the mouth: frontonasal prominence in
the median, bilateral maxillary prominences, and bilateral mandibular
prominences....
...The frontonasal prominence develops into medial and lateral nasal
prominences....
...Over the next week, the two maxillary prominences grow toward the nasal
prominences, meeting the lateral nasal prominences to develop into the nasolabial
region and the medial nasal prominences to create the lip....
...The failure to merge around the end of week five yields a unilateral or
bilateral cleft lip....
...At this time, the development of the palate begins and is complete around week
twelve....
...The medial nasal prominences fuse at the midline to form the median palatine
process or the primary palate....
...With traditional 2D ultrasound, cleft lip is more accurately detected than cleft
palate....
...After birth, cleft palate is easily diagnosed on examination of the neonate....
...Repair is often staged, with the lip managed first, followed by the palate....
...There are several techniques for surgical repair of the cleft lip and palate....
...The most commonly utilized repairs of the lip are the Millard rotation-
advancement technique for unilateral cleft lip and the Mulliken technique for
bilateral....
...Palatoplasty for cleft palate associated with cleft lip and for cleft palate
alone is performed later, at 9-15 months of age....
...Preoperatively, for cleft palate associated with cleft lip, the lip is usually
taped from about one week of life until surgery....