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Cleft Lip and Palate, Pediatric

Oksana A. Jackson, MD and Jesse A. Taylor, MD, FACS Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Cleft lip

    • Deformity of the upper lip that may include a discontinuity of vermilion, skin, muscle, and mucosa as well as the underlying gingiva and bone

    • May be unilateral or bilateral

    • A ...

DIAGNOSIS

HISTORY

  • Prenatal exposure to alcohol, cigarettes, phenytoin, and isotretinoin

  • Family history of cleft lip or cleft palate

  • Speech problems in 1st-degree relative

PHYSICAL EXAM

  • Incomplete or comple...

TREATMENT

GENERAL MEASURES

  • Airway management

    • Prone positioning if the tongue is causing airway obstruction

    • Plastic surgery and ENT consultation if airway obstruction persists

  • Orthodontics

    • Preoperative orth...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Multidisciplinary team for routine visits from infancy to adolescence: 
  • Pediatrician

  • Plastic surgeon

  • Speech pathologist

  • Orthodontist

  • Pediatric dentist

  • Otolaryngologist

  • O...

ADDITIONAL READING

  • Fisher DM, Sommerlad BC. Cleft lip, cleft palate, and velopharyngeal insufficiency. Plast Reconstr Surg.  2011;128(4):342e–360e. [View Abstract on OvidInsights]

  • Heinrich A, Prof...

CODES

ICD9

  • 749.2 Cleft palate with cleft lip, unspecified

  • 749.1 Cleft lip, unspecified

  • 749 Cleft palate, unspecified

  • 749.21 Cleft palate with cleft lip, unilateral, complete

  • 749.02 Cleft palate, unilateral...

FAQ

  • Q: Will there be a scar?

  • A: All cleft lip repairs will leave some type of permanent scar, with potential asymmetry that may benefit from later additional lip scar revision or additional nasal surge...

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