Cleft lip or cleft palate

How cleft lip and cleft palate occurs (For USMLE step 1)? (May 2019).

Anonim

What is a cleft lip?

The word column in this context means an incomplete education. A cleft lip occurs between upper lip and nose. There, certain areas of the face were not properly closed during pregnancy or did not grow together properly.

Some children have only a small notch in their lip. In other children, one or both sides of the lips are pulled up to the nose (Tolarova 2009). In the vernacular, a cleft lip was once called ""harelip"", but this discriminatory term is no longer in use today.

What is a cleft palate?

A cleft palate occurs when the pharynx has not completely closed during development during pregnancy. The posterior upper pharynx is also referred to as the soft palate, the anterior is the hard palate.

A cleft palate may also have different degrees of severity. Some babies have only a small opening in the back soft palate, in other babies almost the entire pharynx is divided. There are also cleft palates that are only bony and closed by the mucous membrane. Thus, on the first examination after birth, the palate must always be scanned to exclude a bony cleft palate.

The cleft palate may be associated with a cleft lip, but both may be separate.

Similar to the cleft lip, the term ""wolf throat"" for a cleft palate is now rejected as discriminatory.

How does a cleft lip or cleft palate develop?

As the baby grows in the stomach, the skull, face and head gradually grow together. Cleft lip or palate develops when some of these areas do not completely unite before birth.

Cleft lip and palate can be passed on in the family. If you have a child, then other children have an increased risk of getting them too. But because there are other causes as well, no reliable predictions about frequency can be made (Sidwell 2009).

Approximately one in 500 children is born in Germany with a cleft palate or cleft lip (Wolfgang-Rosenthal-Gesellschaft), yet the causes are not well understood. However, there are several factors that increase the likelihood of this type of malformation:

  • If the mother drinks and smokes alcohol during pregnancy (Bille 2007, DeRoo 2008, Romitti 2007) the risk increases, though the cause is unknown is.
  • Certain medications may be responsible.If you have a chronic illness and need to take medication, talk to your doctor.
  • The older the parents are, the more often a baby has a cleft lip or cleft palate (Bille 2005).
A folic acid supplement during the first trimester of pregnancy and a healthy diet during pregnancy help reduce the risk (Wilcox 2007).

How long will my baby look like this? How can you treat these malformations?

A cleft lip is usually operated as soon as your baby is two or three months old. So young children usually recover very quickly and therefore only have to stay in the hospital for three to five days. Feeding and breastfeeding is usually unproblematic after the operation, presumably the clinic will show you how to do it right.

A cleft palate is usually targeted only when the baby is one year old, so that jaw growth is minimized. The operation, similar to the cleft lip, is performed under general anesthesia and takes about one and a half hours.

What problems can a cleft lip or cleft palate cause?

Some families are very bothered by the look, though surgical correction can make the malformation almost invisible. The children are worried about their appearance and can develop emotional or social problems over time. But most children handle it very well (Hunt 2005).

A cleft lip or cleft palate can make feeding difficult. In order to get enough to drink, the baby must form a well-closed vacuum in his mouth and the tongue must be in the right place. Already in the first days of life, therefore, a palate plate is inserted, so then breastfeeding is possible because the negative pressure in the mouth can be produced.

If your baby has only a cleft lip, you may be able to breastfeed anyway. Seek help with a lactation consultant or lactation consultant who has experience with cleft lip.

If your baby has a cleft palate, it may not be possible to put your baby on the chest. But you can give your child pumped breast milk (Tolarova 2009b). But you may need a special bottle from which your baby can drink well. Also important is the palate plate for breastfeeding.

As your child grows older, it may have problems pronouncing some words. Then go to a speech therapist and have a speech therapy done until it speaks clearly and clearly. Since the surgery is usually performed in the first year of life, that is before the beginning of the actual own language development, there are fewer problems than before.

Your baby may also be more susceptible to ear infections than other children because the ear is connected to the pharynx via a narrow tube.Hearing tests on your baby may be needed more frequently to make sure that no fluid has accumulated in the middle ear after inflammation. Here then the therapy of choice is the insertion of tympanostomy tubes.

Also, your baby might need special dental treatment. It may take a pair of braces or straps to keep the teeth growing (Tolarova 2009b) and thorough prevention to prevent tooth decay.

Where can I find more information and support?

Further information is available on the website of the Wolfgang-Rosenthal-Gesellschaft, a self-help association for lip-palate malformations e. V …

Sources

Bille C, Skytthe A, Vach W et al. 2005. Parent's age and the risk of oral clefts. Epidemiology 16 (3): 311-6. www. research gate. net [as of February 2011]

Bille C, Olsen J, Vach W et al. 2007. Oral cleft and life style factors - a case-cohort study based on prospective Danish data. Eur J Epidemiol 22 (3): 173-81. www. research gate. net [as of February 2011]

Deroo LA, Wilcox AJ, Drevon CA et al. 2008 First trimester of maternal alcohol consumption and the risk of infantile illness in Norway: a population-based case-control study. Am J Epidemiol 168, 638-46. www. oxford journals. org [as of February 2011]

Honein MA, Rasmussen SA, Reefhuis J et al. 2007 Maternal smoking and environmental tobacco smoke exposure and the risk of orofacial clefts. Epidemiology 18: 226-33. www. journals. lww. com [as of February 2011]

Hunt O, Burden D, Hepper P et al. 2005. The psychosocial effects of cleft lip and palate: a systematic review. Eur J Orthod 27: 274-85. www. oxford journals. org [as of: February 2011]

NHS. 2008. Treating cleft lip and palate . NHS Choices, Health A-Z. www. nhs. uk [as of February 2011]

Romitti PA, Sun L, Honein MA et al. 2007. Maternal periconceptional alcohol consumption and risk of orofacial clefts. Am J Epidemiol 166: 775-85. www. oxford journals. org [February 2011]

Sidwell R, Thomson M. 2009. Cleft lip and palate . Concise paediatrics (second edition). London: Royal Society of Medicine Press.

Tolarova M. 2009a. Overview: Cleft lip and palate . www. emedicine. Medscape. com [As of: February 2011]

Tolarova M. 2009b. Cleft lip and palate: Treatment . www. emedicine. Medscape. com [As of: February 2011]

Wilcox AJ, Lie RT, Solvoll K et al. 2007. Folic acid supplements and risk of facial clefts: national population based case-control study. BMJ 334: 464. www. bmj. com [Date: February 2011]

Wolfgang-Rosenthal-Gesellschaft

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