Cleft lip and palate is a congenital malformation that is classified as syndromic or non-syndromic:
Syndromic refers to the combination of other congenital malformations, such as small mandibular sequence (combined with small mandibular malformation), cleft lip and palate syndrome (combined with lower lip fistula), palatocardiofacial syndrome (combined with a “U” shaped cleft palate and congenital heart disease), and non-syndromic refers to simple cleft lip, cleft palate, and cleft lip and palate.
The incidence of cleft lip and palate in China is about 1.8/1000; male:female=2:1 in simple cleft lip and cleft lip and palate; female>male in simple cleft palate.
What is the main etiology of cleft lip and palate?
It is mainly due to the developmental arrest of the lip and palate mesodermal tissues of the embryonic oral cavity during the early stages of pregnancy (first trimester) and has many causes, including genetic and environmental factors, most of which are the result of a combination of both.
Genetic factors: If one of the parents has cleft lip or palate, the likelihood of having a child with cleft lip or palate increases by 5%; if both parents have cleft lip or palate, the likelihood of having a child with cleft lip or palate increases by 15%; if the first child has a cleft lip or palate, the chance of having a second child with a cleft lip or palate is 25 times higher than if the child has never had a cleft lip or palate.
Environmental factors: what we are talking about here mainly refers to the environment in which the embryo grows and develops, especially the physiological state of the mother and the environment she is in during the first trimester of pregnancy. Such as.
1. short and prolonged periods of excessive stress in the early stages of pregnancy, which can affect the physical condition of the pregnant woman and thus change the chemical nature of her blood
2. viral infections, which affect the embryo through the maternal placenta
3, nutritional deficiencies (such as lack of VitA ,B,E, etc.).
4, drug or chemical poisoning (such as dexamethasone, phenytoin sodium, tetracycline, salicylic acid antipyretic and analgesic drugs, etc.).
5. hypoxia: e.g. pregnant women who move to a plateau or do long trips in a plateau.
6, age: foreign literature reports a predominance of older couples giving birth to children with cleft lip and palate, while young couples are predominant in China.
7, physical injury: such as excessive x-ray radiation.
8. gynecological disorders: can affect the embryo through the placenta, but this statement is currently inaccurate.
When is the treatment time for cleft lip and palate arranged?
1, 1 to 3 months after birth: preoperative orthodontics, or treatment of lip adhesions.
2.3～6 months: cleft lip surgery. Requirements: hemoglobin >10g, white blood cells <10000/mm3, weight >10 pounds (about 4.5kg) (but at present, domestic consideration for safety is more than 10 pounds, or even higher).
3.1～1.5 years old: cleft palate surgery.
4, 3 to 4 years old: cleft palate speech therapy.
5, 6 to 7 years old: taking into account the psychological impact of school on the child. Phase II repair of cleft lip deformity, and correction of cleft palate with incomplete palatopharyngeal closure. (Phase II restoration is not necessary if not necessary).
6. 9 to 11 years of age: repair of cleft alveolar process (i.e., repair of cleft dentition).
7, 11 to 12 years of age: orthodontic treatment for malocclusion may be initiated.
8.16～18 years old: orthodontic treatment for bony secondary malformations of the dentition can be carried out
9.17～19 years old: repair of cleft lip and nose deformity is feasible.