Congenital cleft palate
Cleft palate is commonly referred to as “wolf’s throat” and refers to a cleft in the palate. Cleft palate not only has soft tissue deformities, but most patients with cleft palate also have varying degrees of bone defects and deformities. It is the most common congenital developmental malformation of the oral and maxillofacial region.
Etiology.
Genetic, environmental factors related (same as cleft lip)
Cleft palate subtypes.
1, soft palate cleft: uvula cleft or cleft from the uvula to the soft palate cleft ;
2, incomplete cleft palate: cleft from the uvula to the soft palate, part of the hard palate cleft, that is, the cleft exceeds the junction of hard and soft palate, but does not reach the incisal foramen;
3, unilateral complete cleft palate: cleft from the uvula to the soft palate, hard palate, more than the incisal foramen, oblique to one side directly to the alveolar ridge, often accompanied by one side of the alveolar ridge cleft;
4.Bilateral complete cleft palate: cleft from the uvula to the soft palate, hard palate, beyond the incisal foramen, oblique cleft to both sides, straight to the alveolar crest on both sides, often accompanied by alveolar crest cleft on both sides; the cleft is “Y” type.
Clinical manifestations
1, different degrees of cleft palate;
2, in the newborn and infant, sucking and eating have a significant impact, so that the child is prone to aspiration, resulting in frequent respiratory infections, physical development is backward;
3. Delayed and impaired speech and language development, manifested as slurred pronunciation;
4. Fluid accumulation in the middle ear, affecting hearing;
5.Due to impaired jaw growth and development, the middle part of the face often collapses when the child grows older, especially in adolescence, and in severe cases, the face is disc-shaped and the bite is misaligned.
6, low self-esteem, autism and other psychological disorders.
7, other system deformities, such as congenital heart disease.
Cleft palate treatment.
1.Preoperative orthodontics: palatal brackets are used and started 2 weeks after birth.
2.Cleft palate repair: usually around 1 year old.
3.Voice training: start at 2.5-3 years old.
4.Pharyngoplasty: pharyngoplasty is performed at the age of 5-6 years if there is incomplete palatopharyngeal closure.
5.One-stage orthodontics: performed at the age of 7-10 years, the maxilla is lengthened forward and the baby teeth are removed.
6.Osseous implantation for alveolar ridge cleft: usually performed at the age of 9-11.
7.Phase II orthodontics: performed at the age of 12-14.
8.Orthognathic surgery: generally performed at the age of 16-18 years old.