Description of cleft lip and palate
They are congenital malformations of the face caused by abnormal facial development during spurs the growth of the embryo and fetus.
It is important to mention a little about the development of the face. Initially appear primitive facial projections around primitive mouth. These are the salient frontonasal, paired projections maxillary and mandibular paired projections. From frontonazálního protrusion forms part of the forehead, the nose and the mouth portion close to the nose. For maxillary protrusions formed side portion of the mouth and the residue (bottom) and of the mandibular protrusions. This development takes place between 4th and 8th embryonic week. Since that time has already fetus typically a human face. Another development arises from the mandibular projections lower lip and lower jaw. Development of the upper lip, upper jaw and palate is much more complicated and involved in it remaining 3 facial projections. For this reason, there may occur a large number of development defects.
Cleft lip (cheiloschisis) intervenes only lip; jaw and palate are fine. It looks like a space or rather a notch in the upper lip, but can sometimes go up to the nose. It may be one-sided (unilateral) ortwo-sided (bilateral) and coalescence of failures maxillary projections and parts frontonazálního tip. Very rarely can still occur cleft lower lip. This type of cleft defects is very good surgery to correct the condition.
Cleft palate (palatoschisis) is a condition where bone nesrostou both of the floor. Rarely can also be present cleft palate, and other parts of the oral cavity. If we look at the affected child’s mouth, we can see an opening in the upper part of the oral cavity. This can cause problems when breast feeding and breathing. Nowadays, it is also this very well resolved.
Very rarely they can also appear cleft jaw and other facial parts.
The incidence of these diseases is about one to two disabled children per 1,000 births.
Risk factors rozštěpovýh defects
As we mentioned earlier, the development of the face extremely complicated. On failure involvedgenetic factors (for example, some congenital syndromes) and environmental factors. Thinking about the effect of various pesticides, alcohol, drugs and other addictive substances. Adverse effects may have some drugs, such as anti-seizure medications. On the occurrence of the defect may also participate incorrect mother’s diet and lack of vitamins in the diet. On the other hand, negative effects have been demonstrated related compounds Vitamin A (ie. Retinoids). Some studies have suggested an adverse effect excessive contact with lead. Despite such large list of risk factors will almost always be a combination of various factors.
Prevention Clefts
Cleft have a very wide variety of causes, many of them still unknown. Caution is recommendedduring pregnancy, smoking and drinking alcoholic beverages and other addictive substances.Furthermore, should an expectant mother pay attention to proper diet high in vitamins. On the other hand, it is advised to avoid contact with pesticides, lead and other chemicals.
Signs and symptoms Clefts
Cleft lip is a very aesthetically significant defect which recognizes neonatologist who has been in the delivery room. Cleft palate looks like a hole in the floor when he opens his mouth newborn. It is very important to use a flashlight during an examination, overlooked or defect of small size. This normally investigates already in the hospital.
Affected infants will have problems with breastfeeding because they breastmilk gets into the nasal cavity. Milk can also breathe. For this reason, the condition improves lactation vertically infants when using gravity as much milk not leak. Nowadays, before surgical use special adjusting plate that separates the nasal and oral cavity. Nonspecific symptom may be a common infection of the middle ear. It is also sometimes affected speech and speech understanding. Then there may be the pathologic basis to develop dental problems (missing tooth, excess tooth, badly positioned dentition etc.).
Diagnosis Clefts
Very often Cleft diagnosed at hospital. Immediately after birth, but in the following days the infant is subjected to several examinations when he checked floor and the entire oral cavity. Therefore, defects are discovered very early and treatment begins almost immediately. Rarely can diagnose the defect before birth through ultrasound. On the other hand, sometimes it may not be immediately noticeable defect floors, because it is only cleft bone, which is covered by intact mucous membrane.In this case, the defect appears later Because of the potential complications when using X-rays and other imaging tests.
Treatment Clefts
Nowadays treatment is very successful. Children who have been correctly operated, without scars and does not recognize that they had any defects. First solve cleft lip. The operation is performed very early, because newborns are not yet generating scars and the skin is completely healed. During the first few days of life, newborns plastic surgeon staples the cleft lip. In the Czech Republic this surgery done, for example for plastic surgery University Hospital Vinohrady. If a patient is simultaneously also a cleft palate, it operates with a lip defect and solutions palatal defect was postponed to a later date.
There are several opinions, the operating floor.
One current recommended medical treatment postponed until 10 or 12 years of age. The reason is not to infringe jaw growth and replacement of temporary and permanent teeth and prevent further rekonstruktivním surgery. The downside is the possible development of speech disorders.
The second view is the earlier transactions. The argument is often avoided, as soon as possible breakdowns speech, the correction in later life is difficult. A disadvantage may be such as deformity of the dental arch and the related reconstructive surgery. Until then, than it is corrected cleft palate, using special equipment (pads etc.) that prevent inhalation of milk during lactation. Furthermore, later with the help of a speech therapist treats speech defects. To improve the aesthetics of the position used for the teeth braces.
How can I help treat
Unfortunately, the only treatment is a series of surgical procedures. Therefore, the most important means of compliance when treating the advice and recommendations of doctors and immeasurablepatience of parents.
Complications Clefts
Common complications are inflammation of the middle ear cavity. The reason may be affected by the Eustachian tube. It is the channel that connects the middle ear with the nasopharynx. Its physiological function is to balance the pressure in the middle ear. If for some reason corrupted spread this way bacteria and inflammation occur.
Another complication has already been mentioned eating disorders, where milk and later other food leaking into the nasal cavity. It addresses the special feeding bottles and teats preventing it.Furthermore, patients may have special plates or other aids. These act as a makeshift floor until the final correction.
Very dangerous complications are speech disorders. The correct pronunciation we need a solid floor. If there is a defect, the child will not learn the correct pronunciation and cooperation is needed with a speech therapist. Children with cleft defects have problems with dentition. This is often a missing tooth or vice versa excess tooth or teeth are badly placed. It is therefore necessary corrections orthodontist using braces.
Other names: Cheiloschisis, Cleft Lip, Cleft Palate
