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Encyclopedia > Cleft lip and palate
Look up cleft lip and palate in
Wiktionary, the free dictionary.
Cleft lip and cleft palate
Classification & external resources
Right sided unilateral incomplete cleft lip
ICD-10 Q35-Q37
ICD-9 749

Cleft lip and cleft palate, which can also occur together as cleft lip and palate are variations of a type of clefting congenital deformity caused by abnormal facial development during gestation. This type of deformity is sometimes referred to as a cleft. A cleft is a sub-division in the body's natural structure, regularly formed before birth. A cleft lip or palate can be successfully treated with surgery soon after birth. Cleft lips or palates occur in somewhere between one in 600 and one in 800 births. The term hare lip is sometimes used colloquially to describe the condition because of the resemblance of a hare's lip. Interestingly, in Lun Heng (Chapter 6), the first century AD Wang Chong said, "If a pregnant woman eats rabbit, the baby will have a cleft lip." The Chinese word for cleft lip is tuchun, literally harelip. Wikipedia does not have an article with this exact name. ... Wiktionary (from wiki and dictionary) is a multilingual, Web-based project to create a free content dictionary, available in over 150 languages. ... Image File history File linksMetadata Download high resolution version (2080x1544, 706 KB) Summary This is a picture of a 19 month old male child with unilateral cleft lip, right sided, taken by me with consent from the childs parents. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Cleft may refer to the following: A cleft sentence, a type of grammatical construction Cleft lip, a congenital deformity The Cleft, a location from the Myst series The cleft as a part of the female genitalia This is a disambiguation page: a list of articles associated with the same title. ... ... Gestation is the carrying of an embryo or fetus inside a female viviparous animal. ... For other uses, see Cleft (disambiguation). ... A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ... Birth is the process in animals by which an offspring is expelled from the body of its mother. ... Jack rabbit and Jackrabbit redirect here. ... Wang Chung (27 – 97 C.E.) (Traditional Chinese: 王充; Simplified Chinese: 王充; pinyin: Wáng Chōng) was a Chinese philosopher during the Han Dynasty who developed a rational, secular, naturalistic, and mechanistic account of the world and of human beings. ...


A microform cleft is a very minor cleft where no surgery is required to correct it. A microform cleft can appear as small as a little dent in the red part of the lip or look like a scar.

Contents

Cleft lip

If only skin tissue is affected one speaks of cleft lip. Cleft lip is formed in the top of the lip as either a small gap or an indentation in the lip (partial or incomplete cleft) or continues into the nose (complete cleft). Lip cleft can occur as one sided (unilateral) or two sided (bilateral). It is due to the failure of fusion of the maxillary and medial nasal processes (formation of the primary palate).

Cleft palate

Cleft palate is a condition in which the two plates of the skull that form the hard palate (roof of the mouth) are not completely joined. The soft palate is in these cases cleft as well. In most cases, cleft lip is also present. Cleft palate occurs in about one in 700 live births worldwide.[1] It has been suggested that temporal fenestra be merged into this article or section. ... The hard palate is a thin horizontal bony plate of the skull, otherwise known as the palatine process of the maxilla, located in the roof of the mouth. ... The soft palate, or velum, is the soft tissue comprising the back of the roof of the mouth. ...


Palate cleft can occur as complete (soft and hard palate, possibly including a gap in the jaw) or incomplete (a 'hole' in the roof of the mouth, usually as a cleft soft palate). When cleft palate occurs, the uvula is usually split. It occurs due to the failure of fusion of the lateral palatine processes, the nasal septum, and/or the median palatine processes (formation of the secondary palate). Diagram showing the uvula, tonsils, soft palate, and tongue Uvula without tonsils (after tonsillectomy) The uvula (IPA: ) is a small, mucosa-covered set of muscles, musculus uvulae, hanging down from the soft palate, near the back of the throat. ... The secondary palate exists in species with separate nasal cavities and oral cavities, in order to separate the two. ...

Prevalence among racial groups

Prevalence rates reported for live births for Cleft lip with or without Cleft Palate (CL +/- P) and Cleft Palate alone (CPO) varies within different racial groups. Image File history File links Please see the file description page for further information. ... It is proposed that this article be deleted, because of the following concern: nonsense If you can address this concern by improving, copyediting, sourcing, renaming or merging the page, please edit this page and do so. ... In epidemiology, the prevalence of a disease in a statistical population is defined as the ratio of the number of cases of a disease present in a statistical population at a specified time and the number of individuals in the population at that specified time. ... This article is about race as an intraspecies classification. ...


The highest prevalence rates for (CL +/- P) are reported for Native Americans and Asians. African-Americans have the lowest prevalence rates.[citation needed] See also: rates (tax) A rate is a special kind of ratio, of two measurements with different units. ... Native Americans are the indigenous peoples from the regions of North America now encompassed by the continental United States, including parts of Alaska. ... The term Asian can refer to something or someone from Asia. ... Languages Predominantly American English Religions Predominantly Christianity and Islam Related ethnic groups Sub-Saharan Africans and other African groups, some with Native American groups. ...

Rate of occurrence of CPO is similar for Caucasians, African-Americans, North American Indians and Asians. The 4th edition of Meyers Konversationslexikon (1885-1890) shows the Caucasian race (in blue) as comprising Aryans, Semites and Hamites. The Caucasian race (sometimes called the Caucasoid race) is defined by the Oxford English Dictionary as, relating to a broad division of humankind covering peoples from Europe, western Asia, Middle... Latin America consists of the countries of South America and some of North America (including Central America and some the islands of the Caribbean) whose inhabitants mostly speak Romance languages, although Native American languages are also spoken. ...


Prevalence of “cleft uvula” has varied from .02% to 18.8% with the highest numbers found among Chippewa and Navajo Indians and the lowest generally in African-Americans.[citation needed] Diagram showing the uvula, tonsils, soft palate, and tongue Uvula without tonsils (after tonsillectomy) The uvula (IPA: ) is a small, mucosa-covered set of muscles, musculus uvulae, hanging down from the soft palate, near the back of the throat. ... For other uses of Chippewa, see Chippewa (disambiguation). ... The Navajo (also Navaho) people of the southwestern United States call themselves the Diné (pronounced ), which roughly means the people. They speak the Navajo language, and many are members of the Navajo Nation, an independent government structure which manages the Navajo reservation in the Four Corners area of the United...


Causes of cleft

During the first six to eight weeks of pregnancy, the shape of the embryo's head is formed. Five primitive tissue lobes grow:

a) one from the top of the head down towards the future upper lip;
b-c) two from the cheeks, which meet the first lobe to form the upper lip;
d-e) and just below, two additional lobes grow from each side, which form the chin and lower lip;

If these tissues fail to meet, a gap appears where the tissues should have joined (fused). This may happen in any single joining site, or simultaneously in several or all of them. The resulting birth defect reflects the locations and severity of individual fusion failures (e.g., from a small lip or palate fissure up to a completely deformed face). It is believed that brittany spears once had a cleft lip. The upper lip is formed earlier than the palate, from the first three lobes named a to c above. Formation of the palate is the last step in joining the five embryonic facial lobes, and involves the back portions of the lobes b and c. These back portions are called palatal shelves, which grow towards each other until they fuse in the middle.[2] This process is very vulnerable to multiple toxic substances, environmental pollutants, and nutritional imbalance. The biologic mechanisms of mutual recognition of the two shelves, and the way how they are glued together, are quite complex and obscure despite intensive scientific research. A comprehensive and easy to understand overview of palatal fusion with nice illustrations can be found in the March 2007 issue of Acta Histochemica.


The cause of cleft lip and cleft palate formation can be genetic in nature. A specific gene that increases three-fold the occurrence of these deformities has been identified in 2004 as reported by the BBC.[4]


Environmental influences may also cause, or interact with genetics to produce, orofacial clefting. Scientists have investigated seasonal causes (such as pesticide exposure); maternal diet and vitamin intake; retinoids, which are members of the vitamin A family; anticonvulsant drugs; alcohol; cigarette use; nitrate compounds; organic solvents; parental exposure to lead; and illegal drugs (cocaine, crack cocaine, heroin, etc.) as teratogens that increase the possibility of clefting. The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ...


If a person is born with a cleft, the chances of that person having a child with a cleft, given no other obvious factor, rises to 1 in 14. Research continues to investigate the extent to which Folic acid can reduce the incidence of clefting. Folic acid and folate (the anion form) are forms of the water-soluble Vitamin B9. ...


In some cases, cleft palate is caused by syndromes which also cause other problems. Stickler's Syndrome can cause cleft lip and palate, joint pain, and myopia. Loeys-Dietz syndrome can cause cleft palate or bifid uvula, hypertelorism, and aortic aneurysm. Many clefts run in families, even though there does not seem to be any identifiable syndrome present. Sticklers Syndrome or David-Stickler syndrome or Stickler-Wagner syndrome is a common but little known genetic disorder, which affects the bodys collagen (connective tissue). ... Normal vision. ... Loeys-Dietz syndrome is a recently-discovered autosomal dominant genetic syndrome which has many features similar to Marfan syndrome, but which is caused by mutations in the genes encoding transforming growth factor beta receptor 1 (TGFBR1) or 2 (TGFBR2). ... Uvula (Latin for little grape) can refer to: palatine uvula (this is what is usually meant when no further description is given) uvula of urinary bladder Category: ... Hypertelorism is an abnormally increased distance between two organs or bodily parts, usually referring to an increased distance between the eyes (orbital hypertelorism), seen in a variety of syndromes, including DiGeorge syndrome and Loeys-Dietz syndrome. ... An aortic aneurysm is a general term for any swelling (dilatation or aneurysm) of the aorta, usually representing an underlying weakness in the wall of the aorta at that location. ...


Treatment

Within the first 2-3 months after birth, surgery is performed to close the cleft lip. While surgery to repair a cleft lip can be performed soon after birth, the oft preferred age is at approximately 10 weeks of age, following the "rule of 10s" coined by surgeons Wilhelmmesen and Musgrave in 1969 (the child is at least 10 weeks of age; weighs at least 10 pounds, and has at least 10 g haemoglobin). If the cleft is bilateral and extensive, two surgeries may be required to close the cleft, one side first, and the second side a few weeks later. A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ...


Often an incomplete cleft lip requires the same surgery as complete cleft. This is done for two reasons. Firstly the group of muscles required to purse the lips run through the upper lip. In order to restore the complete group a full incision must be made. Secondly, to create a less obvious scar the surgeon tries to line up the scar with the natural lines in the upper lip (such as the edges of the philtrum) and tuck away stitches as far up the nose as possible. Incomplete cleft gives the surgeon more tissue to work with, creating a more supple and natural-looking upper lip. A top-down view of skeletal muscle Muscle (from Latin musculus little mouse [1]) is contractile tissue of the body and is derived from the mesodermal layer of embryonic germ cells. ... The philtrum (Greek philtron, from philein, to love; to kiss) is the vertical groove in the upper lip, formed where the nasomedial and maxillary processes meet during embryonic development. ...


Often a cleft palate is temporary closed using a palatal obturator. The obturator is a prosthetic device made to fit the roof of the mouth covering the gap. Furthermore a tympanostomy tube is often inserted into the eardrum to aerate the middle ear. This is often beneficial for the hearing ability of the child. There are very few or no other articles that link to this one. ... Tympanostomy tube is a small plastic tube inserted into the eardrum in order to keep the middle ear aerated for a prolonged period of time. ... The tympanic membrane, colloquially known as the eardrum, is a thin membrane that separates the external ear from the middle ear. ... The middle ear is the portion of the ear internal to the eardrum, and external to the oval window of the cochlea. ...


Cleft palate can also be corrected by surgery, usually performed between 9 and 18 months. Approximately 20-25% only require one palatal surgery to achieve a competent velopharyngeal valve capable of producing normal, non-hypernasal speech. However, combinations of surgical methods and repeated surgeries are often necessary as the child grows. One of the new innovations of cleft lip and cleft palate repair is the Latham appliance. The Latham is surgically inserted by use of pins during the child's 4th or 5th month. After it is in place, the doctor, or parents, turn a screw daily to bring the cleft together to assist with future lip and/or palate repair. A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ...


If the cleft extends into the maxillary alveolar ridge, the gap is usually corrected by filling the gap with bone tissue. The bone tissue can be acquired from the patient's own chin, rib or hip.


Speech problems are usually treated by a speech-language pathologist. In some cases pharyngeal flap surgery is performed to regulate the airflow during speech and reduce nasal sounds. // The practice of speech-language pathology includes prevention, diagnosis, habilitation, and rehabilitation of communication, swallowing, or other upper aerodigestive disorders; elective modification of communication behaviors; and enhancement of communication. ... Pharyngeal flap surgery is a procedure to correct the airflow during speech. ...


Most children with a form of clefting are monitored by a cleft palate or craniofacial team through young adulthood. Care can be lifelong.


Note that treatment procedures can vary between craniofacial teams. For example, some teams wait on jaw correction until the child is aged 10 to 12 (argument: growth is less influential as deciduous teeth are replaced by permanent teeth, thus saving the child from repeated corrective surgeries), while other teams correct the jaw earlier (argument: less speech therapy is needed than at a later age when speech therapy becomes harder). Within teams treatment can differ from each individual case depending on the type and severity of the cleft. ... Permanent teeth are the second set of teeth formed in humans. ...


Feeding Tip An infant with a cleft palate will have greater success feeding in a more upright position. Gravity will help prevent milk from coming through the baby's nose if he/she has cleft palate


Craniofacial team

Cleft lip+/- palate is a congenital disorder of the craniofacial complex that occurs early during pregnancy and is present at birth. A cleft palate occurs when the shelves of the palate fail to meet or fuse, resulting in an opening in the roof of the mouth. A cleft lip occurs when the two sides of the lip are separated including the gum and or the upper jaw (http://www.cleftline.org/aboutclp/). Cleft lip+/- palate may affect early feeding, speech , dentition, hearing, velopharyngeal function and psychosocial development. Due to the multifaceted nature of this disorder, a timely coordinated approach by an interdisciplinary cleft palate or craniofacial team is essential to the management and care of this population. According to the American Cleft Palate-Craniofacial Association (ACPA), a cleft palate team provides assessment and treatment for cleft lip +/- palate only, while a craniofacial team provides assessment and treatment for craniofacial anomalies and associated syndromes (Strauss et al., 1998). The minimal requirement for a cleft palate team is a surgeon (see below), an orthodontist, and a speech-language pathologist (Strauss et al., 1998). Involvement of other professionals such as audiologists, psychologists (or other mental health professionals), otolaryngologists, pediatric and general dentists, audiologists, pediatricians, geneticists, social workers, pediatric nurse practitioners; radiologists, and otolaryngologists is not uncommon. Most children with a cleft palate evidence early, and usually treatable middle ear disease (otitis media). Wikipedia does not have an article with this exact name. ... A craniofacial team is a team of medical specialists to treat children (sometimes adults) with facial deformities like lip cleft or palate cleft. ... Image File history File links Broom_icon. ... Hearing is the following: Hearing is the sense by which sound is perceived. ...


The Surgeon, an oral and maxillofacial surgeon or a plastic and reconstructive surgeon, is critical member of the cleft palate team. Their role is to create a functional lip and palate that appears as normal as possible and provides support for the lip and base of the nose. This may, in some cases, require more than one surgery, including initial closure of the lip, initial closure of the palate, lip and nose revision, alveolar bone grafting, and if necessary, closure of oronasal fistula, and/or further palatal or pharyngeal surgery to eliminate hypernasal speech (Peterson-Falzone, Hardin-Jones, Karnell, 2001). Orthognathic surgery to align the upper and lower jaws may also be performed when the child is in his or her teens. The timing of these surgeries range from birth to the teenage years, and is based upon discussions with the orthodontist and surgeon. An Oral and maxillofacial surgeon is a regional specialist surgeon treating the anatomical area of the mouth, jaws and the face as well as associated structures. ... Orthognathic surgery is surgery to correct conditions of the jaw and face related to structure, growth, sleep apnea, or to assist in orthodontic treatment. ...


The Orthodontist, whose specialty is the growth and development of the craniofacial complex, is one of the first cleft palate team members the family may encounter. The orthodontist’s evaluation of the newborn will help determine the timing of required surgeries as the child develops.


The Speech-Language Pathologist is also an essential member of the cleft palate team. Children with cleft palate, while having no trouble with normal language development, can often have delayed speech development due to their mouth's unusual anatomy. The speech-language pathologist will be involved in parent education, newborn feeding instruction, and evaluation and treatment of speech, language, voice and resonance disorders.



The evaluation and treatment of a child with cleft lip +/- palate requires ongoing services from a team of various professionals in a coordinated timely manner. Successful rehabilitation of the child is dependent on continued care by these professionals. Note that not all children with orofacial anomalies will require the care of a cleft palate team. For example, some children with submucous, or occult clefts of the palate, who do not have an impairment of speech/hearing may not need this service.


Velopharyngeal insufficiency

Velopharyngeal insufficiency (VPI) is defined as the failure to close the velopharyngeal sphincter, resulting in an inability to adequately separate the nasal cavity from the oral cavity(Armour et al., 2005) When there is a pharyngeal gap in the velopharyngeal sphincter during speech, air leaks into the nasal cavity resulting in a hypernasal voice resonance and nasal emissions (Sloan, 2000) Secondary effects of VPI include speech articulation errors (e.g., distortions, substitutions, and omissions) and compensatory misarticulations (e.g., glottal stops and posterior nasal fricatives) (Hill, 2001). VPI is most commonly caused by a cleft of the secondary palate, but other causes may include: submucous clefts, neuromuscular abnormalities, and congenital VPI of unknown cause (Sloan, 2000). Additionally, approximately 20-30% of patients develop VPI post primary palatoplasty (Heliovaara et al., 2003). Possible treatment options include speech therapy, prosthetics, augmentation of the posterior pharyngeal wall, lengthening of the palate, and surgical procedures (Sloan, 2000). Look up Sphincter in Wiktionary, the free dictionary. ... The nasal cavity (or nasal fossa) is a large air-filled space above and behind the nose in the middle of the face. ... The mouth, also known as the buccal cavity or the oral cavity, is the opening through which an animal or human takes in food. ... This article or section does not cite any references or sources. ... The word voice can be used to refer to: Sound: The human voice. ... This article is about resonance in physics. ... Articulation may refer to several topics: In speech, linguistics, and communication: Topic-focus articulation Articulation score Place of articulation Manner of articulation In music: Musical articulations (staccato, legato, etc) In education: Articulation (education) In sociology: Articulation (sociology) This is a disambiguation page &#8212; a navigational aid which lists other pages... A distortion is the (usually) undesirable alteration of the original shape (or other characteristic) of an object, image, sound, waveform or other form of information or representation. ... The secondary palate exists in species with separate nasal cavities and oral cavities, in order to separate the two. ... Main Entry: neu·ro·mus·cu·lar Pronunciation: nur-O-m&s-ky&-l&r, nyur- of or relating to nerves and muscles; especially : jointly involving nervous and muscular elements <a neuromuscular junction> ... A congenital disorder is a medical condition or defect that is present at or before birth (for example, congenital heart disease). ... It has been suggested that Speech-Language Pathology, Speech pathology, Phoniatrics be merged into this article or section. ...


Complications

Cleft may cause problems with feeding (see also Haberman Feeder), ear disease, and speech. Due to lack of suction, an infant with a cleft may have troubles feeding. Individuals with cleft also face many middle ear infections which can eventually lead to total hearing loss. Because the lips and palate are both used in pronunciation, individuals with cleft usually need the aid of a speech therapist. Bottle with Haberman feeder The Haberman feeder is a speciality bottle named after its inventor Mandy Haberman for babies with impaired sucking ability (for example due cleft or palate or Mobius syndrome). ...


Psychosocial issues

A cleft palate may impact an individual’s self-esteem, social skills, and behavior. There is a large amount of research dedicated to the psychosocial development of individuals with cleft palate. Self-concept may be adversely affected by the presence of a cleft palate. Research has shown that during the early preschool years (ages 3-5), children with cleft palate tend to have a self-concept that is similar to their peers without a cleft. However, as they grow older and their social interactions with other children increase, children with clefts tend to report more dissatisfaction with peer relationships and higher levels of social anxiety. Experts conclude that this is probably due to the associated stigma of visible deformities and speech abnormalities, if present. Children who are judged as attractive tend to be perceived as more intelligent, exhibit more positive social behaviors, and are treated more positively than children with cleft palate (Tobiasen, 1984). Children with clefts tend to report feelings of anger, sadness, fear, and alienation from their peers. Yet these children were similar to their peers in regard to “how well they liked themselves.” In psychology, self-esteem or self-worth is a persons self-image at an emotional level; circumventing reason and logic. ... Social skills are skills a social animal uses to interact and communicate with others to assist status in the social structure and other motivations. ... For the Pet Shop Boys album of the same name see Behaviour Behavior or behaviour (see spelling differences) refers to the actions or reactions of an object or organism, usually in relation to the environment. ... For other meanings of development used in and outside social sciences, see development. ...


The relationship between parental attitudes and a child’s self-concept is crucial during the preschool years. It has been reported that elevated stress levels in mothers correlated with reduced social skills in their children (Pope & Ward, 1997). Strong parent support networks may help to prevent the development of negative self-concept in children with cleft palate. In the later preschool and early elementary years, the development of social skills is no longer only impacted by parental attitudes but is beginning to be shaped by their peers. A cleft palate may affect the behavior of preschoolers. Experts suggest that parents discuss with their children ways to handle negative social situations related to their cleft palate. A child who is entering school should learn the proper (and age-appropriate) terms related to the cleft. The ability to confidently explain the condition to others may limit feelings of awkwardness and embarrassment and reduce negative social experiences [5].


As children reach adolescence, the period of time between age 13 and 19, the dynamics of the parent-child relationship change as peer groups are now the focus of attention. An adolescent with cleft palate will deal with the typical challenges faced by most of their peers including issues related to self esteem, dating, and social acceptance (Snyder, Bilboul, & Pope, 2005; Endriga & Kapp-Simon, 1999; Pope & Snyder, 2004). Adolescents, however, view appearance as the most important characteristic above intelligence and humor (Prokhorov et al., 1993). This being the case, adolescents are susceptible to additional problems because they cannot hide their facial differences from their peers. Males typically deal with issues relating to withdrawal, attention, thought, and internalizing problems and may possibly develop anxiousness-depression and aggressive behaviors (Pope & Snyder, 2004). Females are more likely to develop problems relating to self concept and appearance. Individuals with cleft palate often deal with threats to their Quality of Life for multiple reasons including: unsuccessful social relationships, deviance in social appearance, and multiple surgeries. Individuals with cleft palate often have lower QOL scores than their peers. Psychosocial functioning of individuals with cleft palate often improves after surgery, but does not last due to unrealistic expectations of surgery.


Having a cleft palate does not inevitably lead to a psychosocial problem. However, it is important to remember that adolescents with cleft palate are at an elevated risk for developing psychosocial problems especially those relating to self concept, peer relationships, and appearance. It is important for parents to be aware of the psychosocial challenges their adolescents may face and to know where to turn if problems arise.


The links below are a source of information regarding parent support networks and social development of children with cleft palate.


Controversy

In some countries cleft lip or palate deformities are considered reasons (either generally tolerated or officially sanctioned) to perform abortion beyond the legal fetal age limit, even though the fetus is not in jeopardy of life or limb. Some human rights activists contend this practice of "cosmetic murder" amounts to eugenics. A London clergywoman, who suffered from a congenital jaw deformity herself (not a cleft lip or palate as is sometimes reported), has started legal action to stop the practice in the UK as reported by CNN[6] and the BBC [7]. Fetus at eight weeks A fetus (alternatively foetus or f&#339;tus) is an embryo in later stages of development, from the third month of pregnancy until birth in humans. ... Human fetus at eight weeks. ... Human rights are rights which some hold to be inalienable and belonging to all humans. ... Eugenics is the self-direction of human evolution: Logo from the Second International Congress of Eugenics, 1921, depicting it as a tree which unites a variety of different fields. ... This article is about the capital of England and the United Kingdom. ...


Famous people born with a cleft

Historical

Name Comments Reference
Tutankhamun Egyptian Pharaoh who may have had a cleft lip according to diagnostic imaging [3]
Doc Holliday Dentist, gambler and gunfighter of the American Old West frontier
Tad Lincoln Fourth and youngest son of President Abraham Lincoln [4]
Thomas Malthus 18th and 19th Century English demographer and political economist

Nebkheperure Lord of the forms of Re Nomen Tutankhaten Living Image of the Aten Tutankhamun Hekaiunushema Living Image of Amun, ruler of Upper Heliopolis Horus name Kanakht Tutmesut The strong bull, pleasing of birth Nebty name Neferhepusegerehtawy One of perfect laws, who pacifies the two lands[1] Wer-Ah-Amun... Pharaoh was the ancient Egyptian name for the office of kingship. ... John Henry Doc Holliday (August 14, 1851 – November 8, 1887) was an American dentist, gambler and gunfighter of the Old West frontier, who is usually remembered for his associations with Wyatt Earp and the Gunfight at the O.K. Corral. ... X-rays can reveal if a person has cavities Dentistry is the practical application of knowledge of dental science (the science of placement, arrangement, function of teeth) to human beings. ... Gambling (or betting) is any behavior involving the risk of money or valuables on the outcome of a game, contest, or other event in which the outcome of that activity is partially or totally dependent upon chance. ... Categories: Stock characters | Stub ... Great Basin region, typical American West The Western United States has played a significant role in history and fiction. ... It has been suggested that this article or section be merged with Thomas (Tad) Lincoln. ... For other uses, see Abraham Lincoln (disambiguation). ... Thomas Robert Malthus, FRS (February 13, 1766 – December 23, 1834), usually known as Thomas Malthus, although he preferred to be known as Robert Malthus, was an English demographer and political economist. ...

Modern

Name Comments Reference
Tom Brokaw American television journalist with NBC News
Carmit Bachar American dancer and singer
Jürgen Habermas German philosopher and sociologist
Wendy Harmer Australian comedian
Michael Helm Canadian novelist
Jesse Jackson American politician, professional civil rights activist and Baptist minister
Stacy Keach American actor and narrator [5]
Annie Lennox Scottish pop musician and vocalist
Tim Lott English novelist
Rita MacNeil Canadian country and folk singer
Peyton Manning American NFL quarterback
Cheech Marin American comedian and actor
Geoff Plant Canadian lawyer and politician, Attorney-General of British Columbia
Jason Robards Academy, Emmy, and Tony Award winning actor
Nikki Payne Canadian comedian and actress
Eric Edgar Cooke Criminal, the last person to be hanged in Western Australia
Mark Hamill American actor and voice actor for video games
Richard Hawley English guitarist, singer, songwriter and producer

The popular belief that Joaquin Phoenix has a cleft lip is mistaken. The mark on his lip is a microform, an almost-cleft that healed itself in utero. If the tissues joined up just enough to create correct bone and muscle tissues, no corrective surgery is required, as is the case with Phoenix. Thomas John Brokaw (born February 6, 1940 in Webster, South Dakota) is a popular American television journalist, presently working on regularly scheduled news documentaries for the NBC television network, and is the former NBC News anchorman and managing editor of the program NBC Nightly News with Tom Brokaw. ... This does not adequately cite its references or sources. ... Carmit Bachar (born September 4, 1974) is an American dancer and singer best known as a member of the successful Pop / R&B group, The Pussycat Dolls. ... A contemporary dancer rehearsing in a dance studio Dance generally refers to human movement either used as a form of expression or presented in a social, spiritual or performance setting. ... Ercole de Roberti: Concert, c. ... This article or section does not adequately cite its references or sources. ... A philosopher is a person who thinks deeply regarding people, society, the world, and/or the universe. ... Sociology is the study of the social lives of humans, groups and societies. ... Wendy Harmer is an Australian comedian, notable for her hosting role of the Australian Broadcasting Corporation variety show, The Big Gig. ... A comedian, or comic, is an entertainer who amuses an audience by making them laugh. ... Michael Helm is a Canadian novelist. ... Jesse Louis Jackson (born October 8, 1941) is an American politician, professional civil rights activist and Baptist minister. ... The Politics series Politics Portal This box:      A politician is an individual who is a formally recognized and active member of a government, or a person who influences the way a society is governed through an understanding of political power and group dynamics. ... Civil rights or positive rights are those legal rights retained by citizens and protected by the government. ... Baptist is a term describing a tradition within Christianity and may also refer to individuals belonging to a Baptist church or a Baptist denomination. ... A minister can mean several things: A government minister is a politician who heads a government ministry A minister of religion is a member of the clergy A minister is the rank of diplomat directly below ambassador This is a disambiguation page &#8212; a navigational aid which lists other pages... Stacy Keach (born Walter Stacy Keach, Jr. ... Actors in period costume sharing a joke whilst waiting between takes during location filming. ... The Narrator is the entity within a story that tells the story to the reader. ... Annie Lennox (born 25 December 1954) is an Oscar, BRIT, Grammy and Golden Globe award-winning Scottish pop musician and vocalist. ... Scottish can refer to: Look up Scottish in Wiktionary, the free dictionary (as an adjective) things to do with Scotland (see also Scots and Scotch) (as a noun) the Scottish people. ... For popular music (music produced commercially rather than art or folk music), see Popular music. ... In music a singer or vocalist is a type of musician who sings, i. ... Tim Lott is a British author, born on 23 January 1956 in Southall, west London. ... Rita MacNeil (born May 28, 1944) is a Canadian country and folk singer from the community of Big Pond on Nova Scotias Cape Breton Island. ... In political geography and international politics a country is a geographical entity, a territory, most commonly associated with the notions of state or nation. ... 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Cleft lip and palate in animals

Cleft lips and palates are occasionally seen in cattle and dogs, and rarely in sheep, cats, horses, and ferrets. Most commonly, the defect involves the lip, rhinarium, and premaxilla. Clefts of the hard and soft palate are sometimes seen with a cleft lip. The cause is usually hereditary. Brachycephalic dogs such as Boxers and Boston Terriers are most commonly affected.[6] An inherited disorder with incomplete penetrance has also been suggested in Shih tzus, Swiss Sheepdogs, Bulldogs, and Pointers.[7] In horses, it is a rare condition usually involving the caudal soft palate.[8] In Charolais cattle, clefts are seen in combination with arthrogryposis, which is inherited as an autosomal recessive trait. It is also inherited as an autosomal recessive trait in Texel sheep. Other contributing factors may include maternal nutritional deficiencies, exposure in utero to viral infections, trauma, drugs, or chemicals, or ingestion of toxins by the mother, such as certain lupines by cattle during the second or third month of gestation.[9] The use of corticosteroids during pregnancy in dogs and the ingestion of Veratrum californicum by pregnant sheep have also been associated with cleft formation.[10] Binomial name Bos taurus Linnaeus, 1758 Cattle (often called cows in vernacular and contemporary usage, or kye as the Scots plural of cou) are domesticated ungulates, a member of the subfamily Bovinae of the family Bovidae. ... Trinomial name Canis lupus familiaris The dog (Canis lupus familiaris) is a domestic subspecies of the wolf, a mammal of the Canidae family of the order Carnivora. ... Species See text. ... Binomial name Felis catus Linnaeus, 1758 Synonyms Felis lybica invalid junior synonym The cat (or domestic cat, house cat) is a small carnivorous mammal. ... Binomial name Equus caballus Linnaeus, 1758 The horse (Equus caballus, sometimes seen as a subspecies of the Wild Horse, Equus ferus caballus) is a large odd-toed ungulate mammal, one of ten modern species of the genus Equus. ... Trinomial name Mustela putorius furo (Linnaeus, 1758) In general use, a ferret is a domestic ferret (Mustela putorius furo). ... The rhinarium is that wet naked surface around the nostrils of the nose in most mammals. ... The premaxilla is a pair of small bones at the very tip of the jaws of many animals, usually bearing teeth, but not always. ... The cephalic index is the ratio of the maximum breadth of the head to its maximum length (i. ... The Boxer is a breed of stocky, medium-sized, short-haired dog with a smooth fawn or brindled coat and square-jawed muzzle. ... The Boston Terrier is a breed of dog originating in the United States of America. ... Penetrance is a term used in genetics that describes the extent to which the properties controlled by a gene, its phenotype, will be expressed. ... The Shih Tzu and Imperial Shih Tzu, in English pronounced // (shee tzoo), in singular and plural,(Traditional Chinese: ; Simplified Chinese: ; pinyin: ; Wade-Giles: Shih-tzu Kou; literally Lion Dog) is a dog breed which originated in China. ... This article or section does not cite its references or sources. ... The Pointer, often called the English Pointer, is a breed of dog developed as a gun dog. ... Charolais cattle are a breed of cattle (Bos Taurus) which originated in Charolais, around Charolles, in France. ... Arthrogryposis (Arthrogryposis Multiplex Congenita) is a muscle disorder that causes multiple joint contractures at birth. ... In genetics, the term recessive gene refers to an allele that causes a phenotype (visible or detectable characteristic) that is only seen in a homozygous genotype (an organism that has two copies of the same allele). ... Texel sheep are bred all over the world, from the USA to Britain. ... Species 150-200 species, including: Lupinus albus Lupinus angustifolius Lupinus luteus Lupinus albifrons Lupinus arboreus Lupinus arizonicus Lupinus bicolor Lupinus chamissonis Lupinus diffusus Lupinus excubitus Lupinus formosus Lupinus longifolius Lupinus microcarpus Lupinus mutabilis Lupinus nanus Lupinus nootkatensis Lupinus perennis Lupinus polyphyllus Lupinus sparsiflorus Lupinus sulphureus Lupinus texensis Lupinus tidestromii Lupinus... Gestation is the carrying of an embryo or fetus inside a female viviparous animal. ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... False Helleborine is a name is used in different parts of the world to describe several different plants of either the Orchid family or the Lily family. ...


Difficulty with nursing is the most common problem associated with clefts, but aspiration pneumonia, regurgitation, and malnutrition are often seen with cleft palate and is a common cause of death. Providing nutrition through a feeding tube is often necessary, but corrective surgery in dogs can be done by the age of twelve weeks.[6] For cleft palate, there is a high rate of surgical failure resulting in repeated surgeries.[11] Surgical techniques for cleft palate in dogs include prosthesis, mucosal flaps, and microvascular free flaps.[12] Affected animals should not be bred due to the hereditary nature of this condition. Aspiration pneumonia is a specific form of lung infection (pneumonia) that develops when oral or gastric contents (including food, saliva, or nasal secretions) enter the bronchial tree. ... Regurgitation is the passive flow of stomach contents back into the esophagus and mouth. ... Percentage of population affected by malnutrition by country, according to United Nations statistics. ... A feeding tube is a medical device used to provide nutrition to patients who cannot or refuse to (cf. ... A United States Army soldier plays foosball with two prosthetic arms Jon Comer, professional skateboarder with a prosthetic leg. ... This article or section is in need of attention from an expert on the subject. ...



See also

It has been suggested that this article or section be merged into cleft lip and palate. ...

Treatment/aids

Oral and Maxillofacial Surgery is a recognized international training course in specialised Medicine, which requires a minimum length of formation of 5 years for a basic medical training and 4 years for a basic medical and dental training, in the European Union. ... Bottle with Haberman feeder The Haberman feeder is a speciality bottle named after its inventor Mandy Haberman for babies with impaired sucking ability (for example due cleft or palate or Mobius syndrome). ... Interplast is the first international humanitarian organization to provide free reconstructive surgery in developing countries, primarily children with cleft lip and palate and burn contracture. ... There are very few or no other articles that link to this one. ... Vomer flap surgery was used prior to 1975 as a surgical treatment for children with cleft palate. ...

Syndromes

Hearing loss with craniofacial syndromes is a common occurrence. ... Popliteal pterygium syndrome (PPS) is an inherited condition affecting the face, limbs, and genitalia. ... Van Der Woude syndrome consists of the following characteristics: cleft lip and palate, missing teeth and lip pits. ...

Organizations

This article or section does not cite its references or sources. ... Transforming Faces Worldwide (TFW) is an international humanitarian organization which provides free surgery and rehabilitation for cleft lip and palate in developing countries. ... The Smile Train is an international charity which helps children suffering from cleft lip and palate. ... The Shriners Hospitals for Children is a hospital network across North America offering free hospital care for children, supported by the activities of the Shriners. ...

External links

Wikimedia Commons has media related to:
Cleft lip

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References

  1. ^ Statistics by country for cleft palate. WrongDiagnosis.com. Retrieved on 2007-04-24.
  2. ^ Dudas et al. (2007): Palatal fusion – Where do the midline cells go? A review on cleft palate, a major human birth defect. Acta Histochemica, Volume 109, Issue 1, 1 March 2007, Pages 1-14
  3. ^ [1]
  4. ^ [2]
  5. ^ [3]
  6. ^ a b Ettinger, Stephen J.;Feldman, Edward C. (1995). Textbook of Veterinary Internal Medicine, 4th ed., W.B. Saunders Company. ISBN 0-7216-6795-3. 
  7. ^ Garcia, J.F. Rodriguez (2006). Surgery of the Soft and Hard Palate. Proceedings of the North American Veterinary Conference. Retrieved on 2007-04-28.
  8. ^ Semevolos, Stacy A.; Ducharme, Norm (1998). Surgical Repair of Congenital Cleft Palate in Horses: Eight Cases (1979–1997) (PDF). Proceedings of the American Association of Equine Practitioners. Retrieved on 2007-04-28.
  9. ^ Mouth. The Merck Veterinary Manual (2006). Retrieved on 2007-04-28.
  10. ^ Beasley, V. (1999). Teratogenic Agents. Veterinary Toxicology. Retrieved on 2007-04-28.
  11. ^ Lee J, Kim Y, Kim M, Lee J, Choi J, Yeom D, Park J, Hong S (2006). "Application of a temporary palatal prosthesis in a puppy suffering from cleft palate". J. Vet. Sci. 7 (1): 93-5. PMID 16434860. 
  12. ^ Griffiths L, Sullivan M (2001). "Bilateral overlapping mucosal single-pedicle flaps for correction of soft palate defects". Journal of the American Animal Hospital Association 37 (2): 183-6. PMID 11300527. 
  • Hill, J.S. (2001). Velopharyngeal insufficiency: An update on diagnostic and surgical techniques. Current Opinion in Otolaryngology and Head and Neck Surgery, 9, 365-368.
  • Liedman-Boshki, J., Lohmander, A., Persson, C., Lith, A., & Elander, A. (2005). Perceptual analysis of speech and the activity in the lateral pharyngeal walls before and after velopharyngeal flap surgery. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 39, 22-32.
  • Mazaheri, M., Athansiou, A.E., & Long, R.E. (1994). Comparison of velopharyngeal growth patterns between cleft lip and/or palate patients requiring or not requiring pharyngeal flap surgery. Cleft Palate-Craniofacial Journal, 31, 452-460.
  • Meek, M.F., Coert, J.H., Hofer, S.O., Goorhuis-Brouwer, S.M., & Nicolai, J.A. (2003). Short term and long-term results of speech improvement after surgery for velopharyngeal insufficiency with pharyngeal flaps in patients younger and older than six years old: Ten year experiment. Annals of Plastic Surgery, 50(1), 13-17.
  • Pena, M., Choi, S., Boyajian, M., Zalzal, G. (2000). Perioperative airway complications following pharyngeal flap palatoplasty. Annals of Otology, Rhinology, Laryngology, 109, 808-811.
  • Peterson-Falzone, S.J., Hardin-Jones, M.A., & Karnell, M.P. (2001). Cleft Palate Speech (3rd ed.). St. Louis, MO: Mosby.
  • Sloan, G.M. (2000). Posterior pharyngeal flap and sphincter pharyngoplasty: The state of the art. Cleft Palate-Craniofacial Journal, 37(Sloan, 2000), 112-122.
  • Tonz, M., Schmid, I., Graf, M., Mischler-Heeb, R., Weissen, J., & Kaiser, G. (2002). Blinded speech evaluation following pharyngeal flap surgery by speech pathologists and lay people in children with cleft palate. Folia Phoniatrica et Logopaedica, 54(6), 288-295.
  • Witt, P.D., Myckatyn, T., & Marsh, J.L.(1998). Salvaging the failed pharyngoplasty: Intervention outcome. Cleft Palate—Craniofacial Journal, 35(5), 447-453.
  • Ysunza, A., Pamplona, C., Ramirez, E., Molina, F., Mendoza, M., & Silva, A. (2002). Plastic and Reconstructive Surgery, 110(6), 1401-1407.
  • Ysunza, A., Garcia-Velasco, M., Garcia-Garcia, M., Haro, R., Valencia, M. (1993). Obsrtuctive sleep apnea secondary to surgery for velopharyngeal insufficiency. Cleft Palate-Craniofacial Journal, 30(4), 387-390.
  • Croen, L.A., Shaw, G.M., Wasserman, C.R., & Tolarova, M.M. (1998). Racial and ethnic variations in the prevalence of orofacial clefts in California, 1983-1992. American Journal of Medical Genetics, 79, 42-47.
  • Peterson-Falzone, SJ, Hardin-Jones, MA and Karnell, MP. (2001) Cleft Palate Speech. (3rd edition). St. Louis: Mosby, Inc.
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  • Marino, V.C.C., Williams, W.N., Wharton, P.W., Paulk, M.F., Dutka-Souza, J.C.R.,& Schulz, G.M. (2005). Immediate and Sustained Changes in Tongue Movement With an Experimental *Palatal “Fistula”: A Case Study. The Cleft Palate-Craniofacial Journal, 42, 286–296.
  • "Maxillofacial Prosthetics." Rhode Island Department of Human Services. Rhode IslandDepartment of Human Services. 10 July 2006<http://www.dhs.ri.gov/dhs/heacre/ provsvcs/manuals/dental/maxpros.htm>.
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  • Resiberg, D. J (2000). Dental and Prosthodontic Care for Patients With Cleft orCraniofacial Conditions. The Cleft Palate-Craniofacial Journal, 37, 534–537.
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  • Endriga, M. C. & Kapp-Simon, K.A. (1999). Psychological issues in craniofacial care: State of the art. The Cleft Palate-Craniofacial Journal, 36, 1.
  • Endriga, M.C., Jordan, J. & Speltz, M.L. (2003). Emotion self-regulation in preschool-aged children with and without orofacial clefts. Journal of Developmental and Behavioral Pediatrics, 24(5). 336-344.
  • Harper, D.C. (1995). Children's attitudes to physical differences among youth from western and non-western cultures. The Cleft Palate Craniofacial Journal. 32.
  • Kapp, K.A. (1979). Self concept of the cleft lip and/or palate children. Cleft Palate Journal. 16, 171-176.
  • Kruckenberg, S.M. & Kapp-Simon, K.A. (1993). Effect of parental factors on social skills of preschool children with craniofacial anomalies. Cleft Palate-Craniofacial Journal, 30, 490-496.
  • Kruckenberg, S.M., Kapp-Simon, K.A. & Ribordy, S.C. (1993). Social skills of preschoolers with and without craniofacial anomalies. Cleft Palate-Craniofacial Journal, 30, 475-481.
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  • Pope, A.W. & Snyder, H.T. (2004). Psychosocial adjustment in children and adolescents with a craniofacial anomaly: Age and sex patterns. The Cleft Palate-Craniofacial Journal, 42, 4.
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  • Pope A.W. & Ward J. (1997). Self-perceived facial appearance and psychosocial adjustment in preadolescents with craniofacial anomalies. Cleft Palate-Craniofacial Journal, 34, 396-401.
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  • Richman, L.C. (1997). Facial and speech relationships to behavior of children with clefts across three age levels. Cleft Palate-Craniofacial Journal, 34, 390-395.
  • Richman, L.C. & Millard, T.L. (1997). Cleft lip and palate: longitudinal behavior and relationships of cleft conditions to behavior and achievement. Journal of Pediatric Psychology. 22, 487-494.
  • Sarwer, D.B. & Crerand, C.E. (2002). Psychological issues in patient outcomes. Facial Plastic Surgery, 18, 2.
  • Snyder, H.T., Bilboul, M.J., & Pope, A.W. (2005). Psychosocial adjustment in adolescents with craniofacial anomalies: A comparison of parent and self-reports. The Cleft Palate-Craniofacial Journal, 42, 5.
  • Tobiasen, J.M. (1984) Psychosocial correlated of congenital facial clefts: a conceptualization and model. Cleft Palate Journal, 21, 131-139.
  • Topolski, T.D., Edwards, T.C., & Patrick, D.L. (2005). Quality of life: How do adolescents with facial differences compare with other adolescents? The Cleft Palate-Craniofacial Journal, 42, 1.
  • Myracel Saguid, S.J, Hardin-Jones, M.A, Karnell, M.P. Cleft Palate Speech, 3rd Edition.(2001) St. Louis: Mosby Inc.
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  Results from FactBites:
 
Cleft Lip and Palate (1486 words)
A child born with a separation in the upper lip is said to have a cleft lip.
Since the lip and the palate develop separately, it is possible for a child to have a cleft lip, a cleft palate, or variations of both.
In some children, a cleft palate may involve only a tiny portion at the back of the roof of the mouth; for others, it can mean a complete separation that extends from front to back.
Cleft Lip and Palate Association of Ireland (361 words)
The Cleft Lip and Palate Association of Ireland (CLAPAI), registered charity, is a voluntary group formed to provide support and information for parents of children affected by cleft lip and palate and those directly affected by the condition.
A cleft palate is an opening in the roof of the mouth.
Clefts result from incomplete development of the lip and/or palate in the early weeks of pregnancy.
  More results at FactBites »

 
 

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