Cleft lips and cleft palates are the most frequent facial deformations: about one case for 800 newborns.

Cleft lips, improperly called " harelips ", result from defects of closure of tissues of the embryonic buttons. These defects occurs early during the 6th and the 12th week of life after conception (in utero)..

Ultrasonic exams give diagnosis before the birth, in about 50 % of cases.

An hereditary factor can be noted in about 30 % of cases ( only or multiple family antecedent). Mostly, the cleft appears as a embryological accident in a family without antecedents.

Left labiomaxillar unilateral cleft (before and one day after intervention)

Result after 6 months

Clefts may be :

  • isolated:
    • uni or bilaterals
    • labial
    • labio maxillary
    • labio maxillo palatine
    • labio maxillo palato velar
  • combined with other malformations:
    • craniofacial: colobome, hypertelorism.
    • ORL: laryngomalacy.
    • cardiac: communications auricular ou ventricular communications or others cono-troncal anomalies.
    • neurological: corpus callosum agenesis
  • associated wit other symptoms:
  • swallowing disorders (notably in Pierre Robin syndrome associating palatovelar cleft, glossoptosis, mandibular hypoplasia, nutrition disorders and respiratory disorders)
  • cardiac rythm disorders.
  • oesophageal motility disorders.

The primary treatment is made by specialized surgeons, according to variable protocols.

The secondary treatments combines surgery but needs cooperation of very different actors as:

  • Stomatologists.
  • Otorhinolaryngologists.
  • Orthophonists.
  • Orthodontists.
  • Psychologists.

 

 

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