Facial appearance oftentimes promp...

Facial appearance oftentimes prompts judgments of personality, intellect and plane character. Thus, it is not surprising that facial foibles provoke anxiety in the parents of an affected child. of that kind is the case with chasm lip and cleft palate deformities. These abnormalities may impede the bonding proces between parents and infant, may cause feeding difficulties, and may delay and impair language development and socialization. The abnormalities may also be associated with airway, otologic, dental and audiologic puzzles and may cause emotional and financial stres With intervention, the prognosis is dutiful especially if the defects are not part of a syndrome of multiple congenital anomalies.

Illustrative Case

A 34-year-old woman neared at 11 weeks' gestation. She had a personal history of crevice lip and cleft palate, which were repaired in infancy. Her first pregnancy had conclusioned in spontaneous abortion at 12 weeks, still she subsequently had three dull pregnancies, with term deliveries of normal male infants.

At 21 weeks, ultrasound examination of the fetus refer toed cleft lip; another ultrasound at 30 weeks showed crevice lip and cleft alveolar ridge however suggested that the palate was intact. The information disturbed the patient and her husband. The patient had be acted uponed from teasing and ostracism in childhood because of her facial deformity. However, she took the moderns about their child with courage and dignity, and prepared her son to accept their brother.

At 40 weeks' gestation, the patient delivered a 3714 g (8 lb 3 oz) lad with Apgar scores of 8 and 9 Labor and delivery were uncomplicated. The infant had a integral right-sided cleft lip and palate. Because the infant was unable to breastfeed, the mother used a breast cross-examine to obtain milk forbottle feeding. Infant weight gain was satisfactory.

At 12 weeks of age, the infant's lip was repaired. At nine month of age, he is an active, alert and essentially well child. Palate repair is scheduled. The infant has experienced several episodes of acute otitis media and has chronic serous otitis. He is scheduled to receive tympanostomy tubes.

Embryogenesis and Anatomy

opening lip and cleft palate are separate yet related fusion disorders of the midfacial skeleton. Mesoderm that migrates from the dorsal paravertebral region ordinarily reinforces fused ectoderm in the developing lip (Figure 1 ) If an insufficient amount of mesodermal ti

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