Materiały źródłowe

• #1 Cleft lip and cleft palate – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cleft-palate/diagnosis-treatment/drc-20370990

  Most cases of cleft lip and cleft palate are seen right away at birth, so special tests aren’t needed. Cleft lip and cleft palate are often seen on ultrasound before a baby is born. […] Healthcare professionals may use ultrasound to find cleft lip, beginning around the 13th week of pregnancy. Sometimes a healthcare professional can find cleft lip earlier using 3D ultrasound techniques. As the unborn baby continues developing, it may be easier to diagnose cleft lip. Cleft palate that occurs alone is harder to see using ultrasound. […] If an ultrasound finds cleft lip or cleft palate, parents can meet with specialists to begin planning for care before birth. […] If cleft lip or cleft palate is found before birth, your healthcare professional will often recommend that you meet with a genetic counselor.

• #2 Cleft Lip & Cleft Palate: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate

  Cleft lip and cleft palate are separations in the upper lip and mouth that occur while a fetus develops in the uterus. Treating cleft lip and palate involves surgery and may include speech therapy and dental work. […] Surgery can repair a cleft lip and/or cleft palate. […] Prenatal ultrasound can diagnose most clefts of the lip because these clefts cause physical changes in the fetus’s face. Isolated cleft palate (with no cleft lip present) is harder to detect this way. Only 7% of these appear on a prenatal ultrasound. […] If an ultrasound doesn’t detect a cleft before birth, a physical exam of the mouth, nose and palate can diagnose cleft lip or cleft palate after birth. […] Most healthcare providers detect cleft lip at your 20-week ultrasound (anatomy scan), which occurs between 18 and 22 weeks of pregnancy. Providers may discover it as early as 12 weeks. It’s more challenging to detect cleft palate on an ultrasound.

• #3 Cleft Lip & Palate Association

  https://www.clapa.com/treatment/diagnosis-birth/

  This section explains a bit more about the diagnosis of a child with a cleft and how this will affect things leading up to (or just after) their birth. […] Based on the most recent statistics compiled by CRANE, around 81% of cleft lips are diagnosed before birth, usually at the 20-week anomaly scan where parents can find out their baby’s gender. […] A regular ultrasound scan cannot reliably identify a cleft palate, either by itself or along with a cleft lip. If you have received a diagnosis of ‘cleft lip and palate’ from a regular ultrasound scan, it’s very likely that what was actually found was a cleft lip and gum. […] Sometimes a cleft lip is not picked up at any scans before birth and can be a big surprise to parents. This is especially likely to happen (30% of cases) if the baby has a cleft lip without a cleft palate.

• #4 Cleft Lip and Cleft Palate Diagnosis and Treatment at OHSU

  https://www.ohsu.edu/doernbecher/cleft-lip-and-cleft-palate-diagnosis-and-treatment

  Cleft lip and cleft palate are common conditions that can be repaired. Our expert team at OHSU Doernbecher Childrens Hospital treats more children with cleft lip or cleft palate than any other hospital in Oregon. We provide the full range of care for your childs speech, hearing, appearance and well-being from shortly after birth to early adulthood. […] Care for your childs cleft depends on the type of cleft and when it is diagnosed. We will guide your family carefully through what may be years of treatment for your child. Your childs care team will stay with your child and family the whole time. […] Cleft lip: You are likely to learn that your baby has a cleft lip before birth. A cleft lip can be seen on a 3D prenatal ultrasound. […] If your child is diagnosed with a cleft lip before birth, you will meet with a pediatric nurse practitioner who can: Explain treatment options, which may include surgery.

• #5 Cleft Lip & Palate Association

  https://www.clapa.com/treatment/diagnosis-birth/

  A cleft palate by itself (called an ‘isolated cleft palate’) is almost impossible to pick up before birth through regular scans, and can be easily missed when a baby is born if it is not looked for. […] National Standards state that a cleft palate should be diagnosed within 48 hours of birth, but some can take days, weeks or even years to be diagnosed. […] Some cleft palates are clearly visible, especially when they involve the hard palate (the bit at the front of the mouth towards the teeth) as well as the soft palate (the bit at the back of the throat). […] With cleft lip and palate, the majority of babies (91%) are diagnosed with a cleft lip before birth, so most parents have a chance to learn more about cleft and prepare for the possibility that their child will have a cleft palate as well.

• #6 Cleft Lip and Cleft Palate Diagnosis and Treatment at OHSU

  https://www.ohsu.edu/doernbecher/cleft-lip-and-cleft-palate-diagnosis-and-treatment

  Cleft palate: Youre unlikely to learn that your baby has a cleft palate before birth, because ultrasounds cant show the inside of your babys mouth. Your childs palate will be checked after birth. […] Your child may have up to 20 appointments in their first year. After this, your child will typically have appointments every six months or once a year. […] Cleft lip surgery usually happens at this age. Your childs surgeon will rebuild affected parts of your childs nose, mouth and face. […] Cleft palate surgery usually happens at this age. The cleft surgeon will close the cleft in the roof of the mouth and rebuild the palate. […] Up to 30% of children with cleft palates develop velopharyngeal dysfunction. It happens when the soft palate does not separate the nose from the mouth enough during speaking or eating.

• #7 【English】What are Cleft Lips and a Cleft Palates? Prenatal Diagnosis and Treatment｜神奈川県立こども医療センター

  https://kcmc.kanagawa-pho.jp/department/plastic/bonelengtheningmethod_copy.html

  Cleft lips and a cleft palates are both congenital defects in which a split occurs in the upper lip and upper jaw, respectively. Although they can be confirmed after birth, they have in recent years been detected increasingly by prenatal ultrasonographic screening before a baby is born. […] A cleft lip can sometimes be detected by prenatal fetal diagnosis. This is because echography (ultrasonography) allows one images to be obtained of the shapes and characteristics of the baby’s face. […] A cleft palate cannot be detected by fetal diagnosis. This is because echographic imaging cannot display the inside of the baby’s mouth. […] Echographic screening can detect cleft lip as early as 20 weeks into pregnancy. More often, however, it may not be noticeable until after 30 weeks. […] A diagnosis of cleft lip or cleft palate is only definitive after birth.

• #8 Accurate diagnosis of prenatal cleft lip/palate by understanding the embryology

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5618146/

  Lateralization of the alar base could help the ultrasonographer to diagnose a complete CLP patient where the visualisation of the CP is difficult. […] An unremarkable uvula, visualised by ultrasound as an equals sign, suggests an intact normal palate. If the ultrasonographer cannot visualise the middle part of the secondary palate, but the equals sign is visible, it is suggestive of an intact palate. This could save the ultrasonographer time.

• #9 Cleft Lip and Palate: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/oral-health/cleft-lip-cleft-palate

  If your baby has signs of a cleft lip or palate on ultrasound, the doctor may take a sample of your amniotic fluid to test for other inherited genetic disorders. It’s not easy to diagnose cleft lip and palate while the fetus is growing in the womb. It’s easier to diagnose by looking at a newborn’s mouth, nose, and palate. Your newborn may also have tests to find other physical changes.

• #10 Cleft lip and cleft palate – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/cleft-lip-and-cleft-palate/

  CL/CP may be diagnosed on prenatal ultrasound (after 12 weeks of gestation). […] If detected prenatally, amniocentesis for karyotyping is offered, to detect other chromosomal abnormalities. […] Postnatal: clinical diagnosis; children with a submucosal cleft palate may present in later life with abnormal speech and/or OME.

• #11 Diagnosing Cleft Lip and/or Palate – myFace

  https://www.myface.org/craniofacial-conditions/cleft-lip-and-or-palate/diagnosing/

  Prenatal ultrasound can detect many cases of cleft lip before birth. […] Many cases of cleft lip are diagnosed during pregnancy, as advances in prenatal ultrasound have made it possible to identify fetuses with cleft lip as early as weeks 13 to 14 of pregnancy. In the second trimester, assessment for cleft lip is part of the routine obstetric exam. […] If a cleft lip is detected on ultrasound, the palate is also carefully assessed, since the majority of infants with cleft lip also have cleft palate. However, standard prenatal ultrasounds are rarely able to detect cases of cleft palate alone. […] When a cleft is detected during a prenatal exam, families are typically offered further evaluation. Further imaging should be done to assess for additional structural anomalies. […] After prenatal diagnosis of a cleft is made, referral to a Cleft Palate/Craniofacial Care Team is recommended. This can help families prepare in advance for the care of the newborn, initiate planning for surgical repair, and connect to a multidisciplinary team to help address potential issues that may impact the child especially breathing, feeding, speech, hearing, and any psychosocial issues.

• #12 Cleft Lip/Cleft Palate | Birth Defects | CDC

  https://www.cdc.gov/birth-defects/about/cleft-lip-cleft-palate.html

  Orofacial clefts, especially cleft lip, can be diagnosed during pregnancy by a routine ultrasound. They can also be diagnosed after the baby is born. Certain types of cleft palate (for example, submucous cleft palate and bifid uvula) might not be diagnosed until later in life. […] Surgery to repair a cleft lip usually occurs in the first few months of life. It is recommended within the first 12 months of life. Surgery to repair a cleft palate is recommended within the first 18 months of life, or earlier if possible. Many children will need additional surgical procedures as they get older.

• #13 Cleft Lip and Palate: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/pediatrics/craniofacial-centers/cleft-lip-palate/treatment

  How Is a Cleft Lip and Cleft Palate Diagnosed? Diagnosis Cleft lip and palate are noticed at birth without special diagnostic tests. A cleft lip can be diagnosed during pregnancy by a routine ultrasound. A cleft palate is usually diagnosed after birth. Submucous cleft palate is usually diagnosed after signs develop. […] Prenatal (before birth) ultrasound is a test that uses sound waves to create images of the fetus. A doctor may detect irregular features in the fetus face. Cleft lip and cleft palate are most often diagnosed around 20 weeks of pregnancy. If cleft lip and/or cleft palate are suspected on a routine ultrasound test, the doctor may recommend a more comprehensive prenatal evaluation.

• #14 Cleft Lip & Cleft Palate – Mary Bridge Children’sLevel Access website accessibility icon.

  https://www.marybridge.org/services/plastic-reconstructive-surgery/maxillofacial-review-board/cleft-lip-cleft-palate/

  Cleft lips and cleft palates are some of the most common major birth defects, occurring in about one or two of every 1,000 infants born in the United States each year. An orofacial cleft occurs when parts of the lip or palate do not completely fuse together during the first three months of pregnancy. […] A cleft lip may be detected through a prenatal ultrasound; however, diagnosing a cleft palate is more difficult, and it may not be seen. The diagnosis and extent of cleft lip and palate is confirmed by physical examination after the birth of the child.

• #15 Cleft Lip and Palate | Ausmed

  https://www.ausmed.com/learn/articles/cleft-lip-and-palate

  When a cleft lip and/or cleft palate is first diagnosed – either by ultrasound scan or at birth – it can be devastating for the parents. […] The earlier the detection, the better, as this allows time for the parents to come to terms with their baby’s altered appearance and the need for surgery. […] McElroy et al. (2017) highlight the importance of early detection by performing a thorough examination of both the hard and soft palate as part of the routine newborn examination. This should include visual inspection using a torch and a method of depressing the tongue to allow examination of the whole palate. […] Costa et al. (2019) conducted research into the care of parents of babies with cleft lip and found that although the majority were satisfied with their overall diagnostic experience, many also reported a perceived lack of sensitivity, knowledge and empathy from hospital staff. Some parents also raised concerns about the implications of a delayed diagnosis, including feeding difficulties. […] The timing and extent of surgery depend on the degree of deformity but usually, the lip can be repaired when the baby is 3 to 6 months old, and the palate at around 9 to 12 months, before the child starts to speak.

• #16 Cleft Lip and Palate: Causes, Diagnosis, & Treatment – BuzzRx

  https://www.buzzrx.com/blog/cleft-lip-and-palate-causes-diagnosis-treatment

  The 20-week ultrasound (also referred to as an anatomy scan) can diagnose a cleft lip and cleft palate as they typically develop between 18 and 22 weeks of pregnancy. […] A cleft lip is easier to diagnose during pregnancy compared to a cleft palate. If a prenatal ultrasound shows a cleft, the doctor may recommend amniocentesis (a sampling of the amniotic fluid) to check for inherited genetic syndromes that can cause birth defects. […] After birth, a cleft lip and palate, especially a cleft lip, is readily visible on the baby’s face. However, some types of cleft palate, such as a bifid uvula or submucous cleft palate, may not be discovered until the child is older.

• #17 Cleft Lip +/- Cleft Palate « Charge Syndrome Foundation

  https://www.chargesyndrome.org/cleft-lip-cleft-palate/

  Diagnosis of Clefts in CHARGE Cleft lip is obvious at birth. The newborn exam performed in the delivery room usually includes an evaluation of the palate. A cleft of the hard palate should be apparent as part of this exam. A submucous cleft is more difficult to diagnose and is sometimes not recognized until much later. […] Cleft lip can be unilateral (UL, one-sided) or bilateral (BL, two-sided). Cleft lip typically occurs between the side and center (cupids bow) portions of the upper lip. It may involve only the lip, or extend into the gum and even into the primary (hard) palate. […] Cleft palate results from a failure of fusion of the palatal shelves. Isolated cleft palate (without cleft lip) is in the back of the palate. It can involve the hard and soft palate or just the soft palate.

• #18 Cleft lip and cleft palate – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cleft-palate/diagnosis-treatment/drc-20370990

  Healthcare professionals usually offer genetic consultation to all parents who have a child born with a cleft lip or cleft palate. […] Treatment involves surgery to repair cleft lip and cleft palate and therapies to make any related conditions better. […] Surgery to correct a cleft lip and cleft palate is based on your child’s situation. […] Healthcare professionals usually do surgeries in this order: Cleft lip repair between 3 and 6 months of age. Cleft palate repair by 9 to 18 months (usually around 1 year) or earlier if possible. This surgery occurs after any cleft lip repair. […] Surgery can improve your child’s quality of life and make your child eat, breathe and talk better. […] Your healthcare professional may recommend more treatment for other functional and structural changes that cleft lip and cleft palate cause, such as: Feeding strategies, such as using a special bottle nipple or feeder.

• #19 Cleft Lip and Palate | Columbia Surgery

  https://columbiasurgery.org/conditions-and-treatments/cleft-lip-and-palate

  Cleft lip can occasionally be diagnosed on ultrasound during pregnancy. Once the baby is born, a diagnosis can often be made with a physical examination alone. Following the cleft lip or palate diagnosis, further tests may be necessary to determine whether the condition is associated with a syndrome, such as velocardiofacial or Pierre Robin syndrome. […] The most common treatment for cleft lip and cleft palate is surgery, which will be decided based on the child’s age, nature of the cleft, and whether the cleft is associated with a syndrome.

• #20 Cleft Lip & Palate Association

  https://www.clapa.com/what-is-cleft-lip-palate/dealing-with-diagnosis/

  If you’ve just had a diagnosis of cleft, either at a scan or after your baby was born, it’s likely you’re full of questions and more than a few emotions! You’ve come to the right place. The Cleft Lip and Palate Association aims to support everyone in the UK affected by cleft, from diagnosis right through to adulthood, and that support begins with the right information. […] You should be referred to one of the NHS Cleft Teams all around the UK. These are teams of medical professionals, from surgeons to psychologists, who all specialise in treating cleft lip and/or palate. This should happen very soon after you’re first diagnosed. If it hasn’t happened yet, ask your obstetrician or midwife about getting a referral. […] The NHS Cleft Team can offer genetic testing, which will look into what may have caused your child’s cleft. This can give you a better idea of how likely it is that any future children in your family will also have a cleft.

• #21 Cleft Lip and Cleft Palate – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-craniofacial-anomalies/cleft-lip-and-cleft-palate

  Cleft lip, cleft lip and palate, and isolated cleft palate are collectively termed oral clefts and are the most common congenital anomalies of the head and the neck, with a total prevalence of 1 per 1000 live births. […] A clinical geneticist should evaluate affected patients even in cases of apparent isolated congenital anomaly. […] Chromosomal microarray analysis, specific gene tests, or broader gene panel tests should be considered in the evaluation of patients with congenital craniofacial anomalies. If the results of these tests are nondiagnostic, whole exome sequencing analysis may be recommended.

• #22 Cleft Lip & Cleft Palate: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate

  You can’t prevent your baby from having cleft lip/cleft palate. However, you may be able to lower the risk by not using cigarettes, alcohol and certain medications during pregnancy. […] Treatment may take many years and require several surgeries. But most children affected by these conditions have a normal childhood. Treatment helps improve speech and feeding issues. […] Problems with eating, hearing and speech are common in children with clefts. Children may also have issues with their teeth or self-esteem. […] Children with cleft palate are more prone to fluid buildup in their middle ears (glue ear). If left untreated, this causes hearing loss. […] Children with cleft palate may have trouble speaking. Their voices may not carry well, and their speech may be difficult to understand. Not all children have these problems, and surgery may solve them.

• #23 Cleft Lip and Palate Evaluation

  https://www.nationwidechildrens.org/specialties/cleft-lip-and-palate-center/about-cleft-lip-and-palate/cleft-lip-and-palate-evaluation

  Nasopharyngoscopy is a procedure that provides a view of the inside of the nose and throat and allows the doctors and speech pathologist to evaluate the child’s velopharyngeal closure (closure of the soft palate against the side walls and back wall of the throat during certain speech sounds). […] Pressure-flow analysis is a special type of speech testing that allows the speech pathologist and doctors to measure the size of the opening between the oral and nasal passageway during speech. […] Children born with cleft palate are at risk for hearing loss due to abnormal function of the muscular tube (called the Eustachian tube) that helps clear fluid from behind your child’s eardrum. […] As part of your child’s team appointment, they will typically undergo hearing testing (called audiometry) and measurement of the function of the eardrum and middle ear space (called tympanometry). […] To improve the quality of your child’s teeth, your child will most likely work with a pediatric dentist, an orthodontist and an oral surgeon, all who will make a coordinated plan to fit your child’s dental needs.

• #24 Cleft lip and cleft palate

  https://www.rch.org.au/kidsinfo/fact_sheets/Cleft_lip_and_cleft_palate/

  Every baby with a cleft palate needs to have their hearing monitored closely by a hearing specialist (audiologist). A hearing assessment should be arranged for when your baby is around four weeks old, and repeated again around 12 weeks of age. […] Your child will need hearing tests, and monitoring by a dentist and speech pathologist experienced in cleft care. […] A child born with cleft lip and cleft palate will require several operations to repair the cleft.

• #25 Cleft Lip and Palate Evaluation

  https://www.nationwidechildrens.org/specialties/cleft-lip-and-palate-center/about-cleft-lip-and-palate/cleft-lip-and-palate-evaluation

  All new patients are evaluated thoroughly by the clinical geneticist who is also a Pediatrician. […] If a specific diagnosis is made, the family is appropriately counseled regarding diagnosis, prognosis, special needs, recurrence risks, and pre-natal testing. […] A perceptual speech evaluation involves a speech-language pathologist listening to your child talk and making judgments regarding their intelligibility (speech clarity), articulation(pronunciation), voice, and resonance (degree of nasality). […] When listening to your child talk, the speech-language pathologist can also obtain important information regarding whether your child may have velopharyngeal dysfunction, a speech disorder sometimes associated with cleft palate, to determine if additional diagnostic tests or treatment are needed.

• #26 Cleft Lip and Palate Evaluation

  https://www.nationwidechildrens.org/specialties/cleft-lip-and-palate-center/about-cleft-lip-and-palate/cleft-lip-and-palate-evaluation

  If there are concerns with your child’s articulation, resonance, or voice, or if velopharyngeal dysfunction is suspected, additional testing will follow and may include standardized testing, Nasometry, Pressure-flow Analysis, and/or Nasopharyngoscopy. […] Nasometry is a non-invasive test performed by the speech-language pathologist during the speech evaluation. […] The speech pathologist then interprets your child’s score (called a nasalance score) relative to a normal cutoff score to determine if further testing or treatment is necessary. […] When the perceptual speech evaluation reveals that a child has hypernasal speech (excessively nasal speech), nasal airflow escaping through the nose during speech (called audible nasal emission), or other symptoms of velopharyngeal dysfunction, it may be helpful to see how structures of the nose and mouth are working to determine what is causing these problems.

• #27 Cleft Lip and Palate Evaluation

  https://www.nationwidechildrens.org/specialties/cleft-lip-and-palate-center/about-cleft-lip-and-palate/cleft-lip-and-palate-evaluation

  Nasopharyngoscopy is a procedure that provides a view of the inside of the nose and throat and allows the doctors and speech pathologist to evaluate the child’s velopharyngeal closure (closure of the soft palate against the side walls and back wall of the throat during certain speech sounds). […] Pressure-flow analysis is a special type of speech testing that allows the speech pathologist and doctors to measure the size of the opening between the oral and nasal passageway during speech. […] Children born with cleft palate are at risk for hearing loss due to abnormal function of the muscular tube (called the Eustachian tube) that helps clear fluid from behind your child’s eardrum. […] As part of your child’s team appointment, they will typically undergo hearing testing (called audiometry) and measurement of the function of the eardrum and middle ear space (called tympanometry). […] To improve the quality of your child’s teeth, your child will most likely work with a pediatric dentist, an orthodontist and an oral surgeon, all who will make a coordinated plan to fit your child’s dental needs.

• #28 Cleft lip and palate – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/675

  Cleft lip with or without cleft palate is approximately twice as common as isolated cleft palate. […] The majority of cleft lip deformities are associated with a varying degree of nasal deformity. […] Oro-facial clefts can occur in isolation or as a component of an identifiable syndrome. They are among the most common birth defects. […] The aetiology of cleft lip and palate involves a variety of genetic and environmental factors that result in variable expressions of oro-facial clefting. […] Comprehensive care involves a multi-disciplinary cleft team with specialists from fields such as facial plastic surgery, genetics, nursing, speech-language pathology, orthodontics, dentistry, oral surgery, audiology, and paediatrics. […] Key diagnostic factors include presence of risk factors, bilateral cleft lip palate, unilateral cleft lip palate, isolated cleft palate, microform cleft lip, isolated sub-mucous cleft palate, and positive antenatal ultrasound.

• #29 Cleft lip and palate – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/675

  Other diagnostic factors include difficulty feeding, poor weight gain, and airway obstruction. […] 1st investigations to order include audiogram and genetics consult. […] Investigations to consider include auditory brain stem response (ABR) test, vertebral spine x-rays, renal ultrasound, fluorescence in situ hybridisation (FISH), and ophthalmic examination.

• #30 Cleft lip and cleft palate – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cleft-palate/diagnosis-treatment/drc-20370990

  Regular screening and treatment for health problems is mostly limited to the first two decades of life, but lifelong monitoring may be needed depending on your child’s individual health problems. […] If your child was diagnosed with cleft lip, cleft palate or both, you’ll need to see specialists who can help create a treatment plan for your child.

• #31 Cleft Lip & Cleft Palate: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate

  Treatment for cleft lip and cleft palate begins at birth. Surgical treatment begins as early as 3 months and can last until the teen years. […] Surgery treats cleft lip and/or cleft palate. The exact details of treatment depend on the extent of the cleft, your child’s age and other special needs or health conditions. […] A cleft lip repair may require one or two surgeries. The first surgery usually occurs when your baby is between 3 and 6 months old. […] Cleft palate surgery usually occurs when your baby is 12 months old. […] Up to 40% of children with a cleft palate will need further surgeries to help improve their speech. […] Because of the number of oral health and medical problems associated with a cleft lip or cleft palate, it takes a team of healthcare providers working together to develop a comprehensive care plan.

• #32 Cleft Lip & Palate Association

  https://www.clapa.com/treatment/diagnosis-birth/

  Your baby will need an operation to repair the cleft. […] A cleft palate is usually repaired within 6-12 months of birth. […] The most important step once the diagnosis has been confirmed is to be put in touch with one of the NHS Cleft Teams around the UK. […] If you are still pregnant, it could be that your obstetric unit wants you to wait for days or even weeks to have a second ultrasound scan. However, if you’ve received a diagnosis of cleft, you should be put in touch with the Cleft Team straight away, and they will aim to contact you within 24 hours. […] If your baby has already been born, you should be visited in the hospital by someone from the Cleft Team and shown how to manage any issues your baby may have with feeding, etc. […] Your Cleft Nurse Specialist or a CLAPA Parent Supporter will be able to answer any questions you have, or at least point you in the direction of someone who can help.

• #33

  https://www.nhs.uk/conditions/cleft-lip-and-palate/

  A cleft lip is usually picked up during the 20-week screening scan done when you’re between 18 and 21 weeks pregnant. Not all cleft lips will be obvious on this scan and it’s very difficult to detect a cleft palate on an ultrasound scan. […] If a cleft lip or palate does not show up on the scan, it’s usually diagnosed immediately after birth or during the newborn physical examination done within 72 hours of birth. […] When a cleft lip or palate is diagnosed, you’ll be referred to a specialist NHS cleft team who will explain your child’s condition, discuss the treatments they need and answer any questions you have.

• #34

  https://www.beaumont.org/treatments/cleft-palate-diagnosis-treatment

  A cleft can sometimes be diagnosed on a prenatal ultrasound. A physical exam upon birth of the nose, lip and mouth confirms the presence of a cleft lip or palate. […] The treatment of an infant with cleft lip and/or palate begins at birth with accurate diagnosis, identification of the child’s needs and multidisciplinary plan of treatment. […] All children with cleft lip and palate should be closely followed by an expert craniofacial team. […] We will work closely with you and your child to: properly diagnose and evaluate the condition, conduct necessary tests (endoscopic, hearing tests, radiologic imaging, etc.), make treatment recommendations, coordinate all diagnostics and care.

• #35 Accurate diagnosis of prenatal cleft lip/palate by understanding the embryology

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5618146/

  Cleft lip with or without cleft palate (CP) is one of the most common congenital malformations. Ultrasonographers involved in the routine 20-wk ultrasound screening could encounter these malformations. […] For ultrasonographers involved in screening these patients it is crucial to have a thorough understanding of the embryology of the face. This could help them to make a more accurate diagnosis and save time during the ultrasound. […] The aim of this review is to familiarize the ultrasonographer with the embryology of the face, which will subsequently aid in more accurate diagnosis of the extent of the facial cleft. […] Knowledge of the embryology of the face should add to the understanding and correctly diagnosing OFCs. Failure of fusion between any of the facial swellings results in facial clefts and can occur either unilaterally or bilaterally and typically happens at the junction of the lateral incisor and the first premolar teeth.

• #36 Prenatal ultrasonographic diagnosis of cleft lip with or without cleft palate; pitfalls and considerations | Maxillofacial Plastic and Reconstructive Surgery | Full Text

  https://jkamprs.springeropen.com/articles/10.1186/s40902-015-0019-z

  Ultrasonographic examination is widely used for screening of abnormal findings on prenatal screening. Cleft lip with or without cleft palate of the fetus can also be screened by using ultrasonography. Presence of abnormal findings of the fetal lip or palate can be detected by the imaging professionals. However, such findings may not be familiar to oral and maxillofacial surgeons. […] An accurate prenatal diagnosis of the lip and palate anomaly is critical for establishing adequate long-term treatment planning, prediction of prognosis, and proper counseling with the parent. […] The accuracy of sonography for prenatal diagnosis of CL CP is highly variable and dependent on the experience of the sonographer, maternal body habitus, gestational age, fetal position, and the amount of amniotic fluid and the type of clef.

• #37 Cleft Lip & Cleft Palate Surgery: Repair Steps & Post-op Care

  https://my.clevelandclinic.org/health/treatments/23394-cleft-lip-cleft-palate-surgery

  Cleft lip and cleft palate are separations, or splits, in the lip and mouth of an infant. Its a congenital disorder, which means it happens while a fetus is still in the uterus. A cleft occurs when tissues dont join together properly during fetal development. […] Cleft lip and cleft palate surgery help restore function to your childs lips and mouth and correct their appearance. Cleft lips and palates are associated with health problems like hearing loss, dental problems and speech problems. […] Surgery to fix cleft lip typically occurs when a child is 3 to 6 months old. […] Cleft palate surgery generally occurs when a child is around 12 months old (before your child learns to talk). […] Several healthcare providers are involved in your childs care, including surgeons, speech therapists, otolaryngologists (head and neck surgeons) and dentists. Your childs surgeon will meet with you to evaluate your childs cleft palate or cleft lip and determine the best surgical treatment.

• #38 Cleft palate and cleft lip | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cleft-palate-and-cleft-lip

  A cleft lip can be treated with lip repair surgery. This usually happens when the baby is around three to six months of age. […] Cleft palates have to be surgically repaired before the baby is ready to speak, usually between nine months and one year. During the operation, nearby mouth tissue is used to close over the cleft. Some children will require further operations, such as pharyngoplasty, to help seal the mouth from the nasal cavity.

• #39 Cleft palate and cleft lip | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cleft-palate-and-cleft-lip

  A cleft lip or cleft palate (or both) is a birth condition in which parts of the mouth do not join up during early fetal development. […] A cleft lip is often detected on ultrasound at 20 weeks gestation, however a cleft palate can be more difficult to detect at this time. A prenatal diagnosis provides an opportunity for parent education, counselling and support. A thorough examination of a babys face and mouth at birth is required to diagnose the type and severity of the cleft. […] A cleft lip or cleft palate (or both) is not caused by anything the parents did or did not do during the pregnancy. Even the healthiest, well-planned pregnancies can result in a cleft, and this is no ones fault. […] Babies born with a cleft lip or cleft palate (or both) will need care from a multidisciplinary team of specialists from a cleft and craniofacial anomalies service. This is also known as a cleft clinic or cleft team. Your baby will be referred to a cleft team at birth or soon after. A cleft coordinator will help guide you through the process of seeing these specialists and caring for your baby.

• #40 Cleft Palate – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563128/

  After birth, neonates with CL/P will require evaluation and care from an interprofessional healthcare team. The initial assessment is focused on respiratory and feeding issues to ensure the infant can grow and develop appropriately until the definitive surgical repair. […] The management of cleft palate ideally involves prenatal and postnatal treatment with an interprofessional team.

• #41 Cleft lip and cleft palate

  https://www.rch.org.au/kidsinfo/fact_sheets/Cleft_lip_and_cleft_palate/

  Cleft lip and cleft palate describe an abnormal gap in either the upper lip or the roof of the mouth (the palate). It occurs when some parts of the mouth fail to join together during early pregnancy. The lip and palate develop separately, which means it is possible for a baby to be born with only a cleft lip, only a cleft palate, or a combination of both. […] Most of the time, cleft lip or cleft palate is detected during routine scans in pregnancy. […] The treatment required for a child with a cleft lip or cleft palate depends on the diagnosis at birth. A cleft lip may need only one operation in the first year of life. A child with a large cleft involving the lip and palate will need several operations. Your child’s surgeon will explain your child’s surgical plan to you. […] Your child will see the cleft team from birth until their face has finished growing (usually in their late teens).

• #42 Cleft Lip and Palate

  https://www.asha.org/practice-portal/clinical-topics/cleft-lip-and-palate/?srsltid=AfmBOoqB1d890M781MJEhuV0JrMgK8qYGYPOjvc0oV0lZrXhFM9eOzdr

  The goal of feeding intervention is to ensure adequate and efficient intake for appropriate hydration and nutrition, for growth and development, and for adequate medical status prior to surgery. […] A number of strategies and techniques can be used to facilitate feeding success prior to surgery. […] Surgical intervention or other physical management is needed to manage speech disorders resulting from VPD (e.g., hypernasality); hyponasality due to enlarged adenoids or enlarged turbinates; pervasive nasal air emission (and/or weak pressure on oral consonants); and malocclusion. […] Direct speech therapy is appropriate for treatable articulation disorders, including compensatory misarticulations and phoneme-specific nasal air emission due to a pharyngeal placement on sibilants. […] Early speech and language intervention can lessen the impact of these factors on the development of communication skills in infants and toddlers. […] SLPs play a role by teaching parents how to engage in vocal play with their children before surgery; how not to reinforce compensatory productions; and how to provide intensive language stimulation.

• #43 Cleft Lip and Cleft Palate Diagnosis and Treatment at OHSU

  https://www.ohsu.edu/doernbecher/cleft-lip-and-cleft-palate-diagnosis-and-treatment

  Your care team will help you find a dentist in your community who can provide follow-up care for cleft lip and cleft palate. […] Children may start orthodontic care to straighten their teeth and improve how their jaws work. […] Children who had a cleft lip may have surgery when their face is fully developed to reduce scarring and improve appearance. […] Older teens may have nose and jaw surgery after theyre done growing to improve function or appearance.

• #44 The Comprehensive Prenatal Diagnostic Workup for Cleft Lip/Palate | Children’s Hospital of Philadelphia

  https://www.chop.edu/news/comprehensive-prenatal-diagnostic-workup-cleft-lippalate

  Cleft lip with or without cleft palate is the most common craniofacial anomaly detected on routine prenatal screening ultrasound. […] In each case of suspected orofacial cleft, the primary goals at our institution are determining whether the defect is unilateral or bilateral, whether the defect is confined to the lip or involves the palate, and whether the defect is isolated or associated with other congenital anomalies. […] Ultrasound and MRI are complementary modalities in the assessment of all facial clefts, and patients referred to our Center for Fetal Diagnosis and Treatment typically undergo both examinations. […] Knowing whether the cleft involves the palate is another important component in preparing parents for what to expect with respect to postnatal surgical management. […] MRI is especially valuable in assessing both the hard and soft palate and traditionally has been superior to ultrasound in detailing defects of the palate.

• #45 Prenatal ultrasonographic diagnosis of cleft lip with or without cleft palate; pitfalls and considerations | Maxillofacial Plastic and Reconstructive Surgery | Full Text

  https://jkamprs.springeropen.com/articles/10.1186/s40902-015-0019-z

  Prenatal diagnosis of orofacial cleft gives the parents the possibility to prepare themselves in an emotional and practical way. […] For an effective counseling, accuracy of diagnosis is essential. Diagnosing techniques have been dramatically improved throughout the decades by technology, equipment and skills. However, health professionals must be aware of the possible pitfalls and related considerations of the ultrasonographic diagnosis for better treatment planning and counseling.

• #46 The Comprehensive Prenatal Diagnostic Workup for Cleft Lip/Palate | Children’s Hospital of Philadelphia

  https://www.chop.edu/news/comprehensive-prenatal-diagnostic-workup-cleft-lippalate

  The last component of evaluation at our hospital is to establish whether the defect is isolated or associated with other anomalies. […] A prenatal diagnosis of cleft lip with or without palate can be difficult for expecting parents to receive. […] Members of our fetal imaging team make every effort to provide the maternal-fetal medicine specialists and plastic surgeons with the most comprehensive assessment of the facial cleft so that patients receive the most accurate counseling and preparation for postnatal treatment.

• #47 Cleft Lip | Causes, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/c/cleft-lip-repair

  Cleft lip is diagnosed at birth but can often be diagnosed before your child is born during an ultrasound. The cleft lip is typically visible on the ultrasound around the 30-week mark or later. […] If your child has been diagnosed before birth, we recommend meeting with our prenatal counselors, including team members from Human Genetics, and with our surgeons. […] Based on the findings of the ultrasound, team members from Human Genetics may recommend other tests.

• #48 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/face/facial-cleft

  Investigations: […] Detailed ultrasound examination. […] Invasive testing for karyotyping and array. […] Follow-up: […] Follow-up should be standard. […] Prenatal consultation with multidisciplinary team. […] Delivery: […] Standard obstetric care and delivery. […] Prognosis: […] This primarily depends on the presence and type of associated anomalies. […] Isolated: Good prognosis and normal survival. […] Surgical repair is at 3-6 months of age. […] Long-term issues in children with cleft lip and palate include dental abnormalities, hearing and olfactory problems, midface hypoplasia, and psychological problems. About 25% have speech abnormalities requiring secondary palate surgery and speech therapy. Dental anomalies include missing, extra, or malpositioned teeth and they require braces on their permanent teeth. Most children have hearing abnormalities and may require myringotomy with placement of bilateral tympanotomy tubes to improve hearing. Regular psychological screening is recommended to assess the child’s cognitive development, behavior, and self-image. […] Recurrence: […] Isolated: 5% if one sibling or parent is affected and 10% if two siblings are affected. […] Syndromic: all forms of inheritance have been described, including autosomal dominant, autosomal recessive, X-linked dominant and X-linked recessive.

• #49 Cleft Lip/Cleft Palate | Cooper University Health Care

  https://www.cooperhealth.org/services/cleft-lipcleft-palate

  A cleft lip may be diagnosed in pregnancy during a routine ultrasound. It will usually be visible during a babys first examination, although some types of cleft palate arent easily visible and might not be diagnosed until later in life. […] Treatment for children with cleft lip or palate depends on the size of the cleft, the childs age and needs, and whether there are additional problems related to a genetic syndrome. A child with cleft lip or palate is often referred to a team of experts that may include an otolaryngologist (ear, nose, and throat doctor), plastic surgeon, oral surgeon, speech pathologist, pediatric dentist, orthodontist, audiologist, pediatrician, nutritionist, and psychologist/social worker. Because cleft lip and palate are so often part of genetic syndromes, a thorough medical examination and genetic counseling is recommended for children and their parents to find out whether their future children may be affected.

• #50 Cleft Lip and Palate: Causes, Treatment, and Outlook

  https://patient.info/ears-nose-throat-mouth/cleft-lip-and-palate-leaflet

  Following the initial cleft repair, your doctor may recommend follow-up surgeries to improve speech or improve the appearance of the lip and nose. […] If CLP is left uncorrected, psychological problems are likely to occur. These include problems with self-image, behaviour, anxiety and depression. There are many charities working in lower income countries to correct CLP in babies who might otherwise grow up to have these difficulties. […] Your baby should achieve a normal appearance, and normal speech and eating habits very early in the process.

Zobacz więcej