Cleft lip

presented by HAFIZ M WASEEM
university of education LAHORE Pakistan
i am from mailsi vehari and studied in lahore
bsc in science college multan
msc from lahore

1. CLEFT LIP HAFIZ M WASEEM UNIVERSITY OF EDUCATION LAHORE

2. CONTENTS INTRODUCTION TYPES CHANGES IN PREGNANCY CAUSES FAMILY RELATIONS HUMAN TERATOGENS DIAGNOSIS TREATMENT CONCLUSION REFERENCES

3. INTRODUCTION Cleft: means fissure FACIAL CLEFT: a fissure resulting from incomplete merging or fusion of embryonic processes normally uniting in the formation of face There is an excess of males with cleft lip 2:1 Female excess has been reported in isolated cleft palate cases 25% - CLEFT LIP

4. INTRODUCTION A cleft lip is type of birth defect that affects the upper lip. Cleft lip ( cheiloschisis ) is the most common congenital malformation since prehistoric times. Occurs in a well-defined places, along definite axis.

5. TYPES OF CLEFT LIP Partial or incomplete cleft It is formed in the top of lip as either a small gap or an indentation in the lip Complete cleft Or it continues into the nose Unilateral or bilateral cleft It is due to the failure of fusion of the maxillary prominence and medial nasal processes (formation of the primary palate).

6. Changes in pregnany Neural crest cells play an important role in facial morphogenisis Just before neural fold fuse to form neural tube, neuro ectodermal cells adjacent to neural plate migrate to facial region These cells form the skeletal and connective tissues of the facelike bone, cartilages, fibrous tissue, dental tissue

7. Development of face is controlled by 2 organic centres Procencephalic organizer – induces the formation of upper 3 rd of the face Rombencephalic organizer – forms the middle and caudal 3 rd of face

8. 4 th week – stomedium (primitive oral cavity) is covered by maxillary, mandibular and fronto nasal prominence

9. 5 th week – nasal placodes arise as thickning of either side of the frontal prominence Horse shoe shaped ridge consisting of medial and nasal swelling surrounds each nasal placodes As mesenchyme elevates the ridge the nasal pits are formed

10. 6 th and 7 th week Two mandibular prominence emerge in the midline The maxillary prominence fuse with medial nasal prominence

11. CAUSES The exact cause of clefting is unknown Multifactorial Chemical exposure, radiations, maternal hypoxia, teratogenic drugs, nutritional deficiencies, physical obstruction, and genetic influences.

12. The syndromal were classified by pashayan in 1983 into: Major mutant genes usually with a known mendelian inheritance pattern such as Treacher -Collins, Stickler or van der Woude syndrome. Chromosomal abnormalies such as the trisomy (D,E, and P) Teratogenic syndromes secondry to drug and alcohol ingestion as Fetal alcohol syndrome, Fetal phenytoin syndrome, Fetal valproate syndrome

13. Family relation Affected relatives predicted recurrence CL 1 sibling 4.4% 1 parent 3.2% 1 sibling, 1 parent 15.8%

14. HUMAN TERATOGENS CAUSING CLEFT Ethyl alcohol Diphenyl hydantoin Trimethadione Retinoids Methotrexate Hyperthermia Smoking

15. Diagnosis Prenatal ultrasound _ 2D or 3D Prenatal counseling 22% to 33% rates for detecting facial clefts 73% - fetal cleft lip Color doppler ultrasonography can also be used

16. TREATMENT Can be successfully treated with surgery Often done in the first few months of life Speech therapy and dental care may also be needed With appropriate treatment, outcomes are good

17. CONCLUSION The management of cleft lip is necessary at correct time. If delayed in the treatment there may be possibility to developed abnormalities. So to prevent some problems like speech problems, facial asymmetry , feeding problem and infection to nasal cavity and unasthetic appearance. The treatment is necessary.

18. REFERENCES Mai CT, Isenburg JL, Canfield MA, Meyer RE, Correa A, Alverson CJ, Lupo PJ, Riehle‐Colarusso T, Cho SJ, Aggarwal D, Kirby RS. National population‐based estimates for major birth defects, 2010–2014.  Birth Defects Research.  2019; 111(18): 1420-1435. Little J, Cardy A, Munger RG. Tobacco smoking and oral clefts: a meta-analysis. Bull World Health Organ. 2004;82:213-18 . https://www.mayoclinic.org/diseases-conditions/cleft-palate/symptoms-causes/syc-20370985