Cleft lip and palate.

Abstract

1. Mary-Alice Abbott, MD, PhD* 1. *Department of Pediatrics, Division of Medical Genetics, Tufts University School of Medicine, Baystate Medical Center, Springfield, MA. Editor’s Note: In the recently published article “Causal Attributions of Cleft Lip and Palate Across Cultures” (Cleft Palate Craniofac J. 2013;50[6]:655–661), the authors state that, across the world, culturally held beliefs concerning cleft lip and palate can have deleterious social effects on children and their families. Our readers should keep this in mind as they read the following article. Joseph A. Zenel, MD Editor-in-Chief Physicians should be aware of the potential associated medical problems with orofacial clefts, including airway obstruction, feeding difficulties, speech and language abnormalities, otitis media, and underlying genetic syndromes. After completing this article, readers should be able to: 1. Understand the role of genetics and environmental factors in the incidence of orofacial clefts. 2. Be aware of the availability of special nipples and bottles for feeding some infants with orofacial clefts. 3. Recognize the associations between cleft palate and airway issues (Pierre Robin sequence) and palatal dysfunction and otitis media. Oral-facial clefts are a common birth defect, occurring in approximately 1 in 600 US live births. (1) Epidemiologic studies have found that incidence varies according to sex and ethnic background; clefts occur most commonly in Native American and Asian populations and are least common in those with African heritage. Clefts of the lip are associated with a palatal cleft in approximately two-thirds of affected individuals. Cleft lip with or without cleft palate occurs more often in males, whereas isolated cleft palate is seen more often in females; cleft lip with or without cleft palate is more frequent that cleft palate alone. Facial development is a complex process. Five structures are involved in the development of the fetal face: the median frontonasal prominence, …