Cleft palate

Introduction to cleft palate Cleft palate is more common and can occur alone or in combination with cleft lip. Cleft palate has not only soft tissue malformations, but most patients with cleft palate can also be associated with varying degrees of bone defect and deformity. It is far more serious than cleft lip in terms of physical dysfunction such as sucking, eating and language. Due to the growth and development of the jaw bone, it often leads to the collapse of the middle part of the face. In severe cases, it is a dish-shaped face, and the bite is disordered (often anti-jaw or open jaw). Therefore, a variety of physiological dysfunction caused by cleft palate deformity, especially language dysfunction and tooth disorder, have adverse effects on patients' daily life, study and work, and are also likely to cause psychological barriers for patients. basic knowledge The proportion of illness: 0.001% Susceptible people: young children Mode of infection: non-infectious Complications: speech and language barriers in children

Cause of cleft palate

Genetic factors (50%):

There are three main theories about the causes of cleft lip and palate: 1 It is believed that multiple genes in patients with cleft lip and palate have a genetic predisposition. When the effects of multiple genes are superimposed to a certain extent, cleft lip and palate will occur; The threshold of cleft lip and palate occurs. The threshold is affected by the combination of multiple genes and environmental factors. 3 It is believed that the occurrence of cleft lip and palate is controlled by a single major gene. The theory currently accepted by most scholars is still the threshold theory of the multi-factor and multi-factor combination of multiple factors.

Environmental factors (30%):

Although the influence of environmental factors is not as obvious as the influence of genes, it still plays an important role in the occurrence of cleft palate, especially the comprehensive effect of genes, which is an important cause of abnormal development of blasts. Suspicious environmental factors are:

(1) Maternal environment: refers to changes in the anatomy and physiology of the mother, such as hypoxemia due to insufficient blood supply, changes in intrauterine pressure and amniotic fluid. When the maternal hormones and metabolites are disordered, it is also possible to affect the development of the embryo through the placenta. Some scholars have reported that the incidence of congenital malformations in women with diabetes is more than three times that of the normal population. The mother of thyroxine deficiency is also prone to the production of cleft lip and palate. In addition, abnormal metabolism of phenylalanine has been found in the production of cleft lip and palate. Antibodies against the embryonic tissue produced in the mother can also affect the normal development of the fetus.

(2) Infection: viruses, bacteria and protozoa can infect the mother, placenta and embryos. Rubella virus and cytomegalovirus are currently proven viruses that play an important role in human congenital malformations. In addition, influenza virus A2 and virus H1 have a certain relationship with the occurrence of congenital facial deformities with cleft lip and palate. Toxoplasmosis infection can occasionally lead to congenital malformations. The investigation found that the probability of maternal infection of parasites in children with congenital facial fissure was 2 to 4 times higher than that of the control group.

(3) Drugs: Antagonists of aminopterin and folic acid have been found to have a definite teratogenic effect on human and animal embryos. Anticonvulsants (such as phenytoin) are teratogenic to humans with cleft lip and palate, and the chance of causing cleft palate is greater than cleft lip and cleft lip and palate. In addition, some drugs have been confirmed in animals to induce congenital cleft lip and palate, such as drugs containing N-hydroxy-N-formylglycine structure in antibiotics, anti-cell mitosis drugs such as vincristine, and even aspirin (acetyl chloride) Salicylic acid, cortisone, etc., of which cortisone has the possibility of increasing the incidence of cleft palate in pregnant women. In addition, many domestic scholars reported that mothers of children with cleft lip and palate have a history of taking cold medicines such as cold granules and antipyretic and painkillers in the first 3 months of pregnancy.

(4) X-ray: There is no affirmative conclusion on whether there is a higher incidence of cleft lip and palate in women than X-ray after pregnancy. However, it has been confirmed in animal experiments that X-ray is one of the effective means to induce experimental animals to produce cleft lip and palate embryos.

(5) Smoking and drinking: Studies have confirmed that smoking women are twice as likely to produce cleft lip and cleft lip and palate. Although there is no evidence to confirm the inevitable link between excessive alcohol consumption during pregnancy and increased incidence of cleft lip and cleft lip and palate, there is indeed a typical alcoholic fetus syndrome, which may be associated with cleft lip and palate. defect. In the experiment, it was also found that the morphology of the embryos was different after injection of alcohol in mice with cleft lip and palate sensitivity and non-sensitive mice.

(6) Vitamins: The use of vitamins during pregnancy can prevent or reduce the occurrence of congenital malformations such as cleft lip and palate. For example, Luo Liang et al found in animal experiments that vitamin B12 can effectively reduce the incidence of congenital cleft palate in A/J mice with dexamethasone teratogenicity by 40%; Briggs and Tolarova use vitamin B6 and folic acid to prevent pregnant women from producing congenital Studies in children with cleft lip and palate have been shown to be 2/5 to 1/3 lower than the control group. A relatively positive understanding is that vitamins can be prevented and reduced by about 20% of cleft lip and palate. But at the same time, it is also found that large doses of vitamin A have the effect of inducing congenital cleft palate, so taking a small amount of vitamin A during pregnancy is beneficial to the development of the fetus, but if the dose is too large, if it exceeds 10.000 IU per day, it will induce The danger of chapping.

Splitting prevention

Pregnant women should avoid partial eclipse during pregnancy, ensure adequate intake of vitamins B, C, D and calcium, iron and phosphorus, maintain peace of mind, avoid mental stress, do not take anti-tumor drugs, anticonvulsants, histamine, treatment of morning sickness Kemin Jing and some sleeping pills, do not smoke without alcohol, avoid contact with radiation, microwave, drink or not drink coffee.

Cleft palate complications Complications Children's speech and language barriers

As a congenital developmental defect, cleft palate varies with age, including the physiological developmental defects of the malformation itself, the secondary changes in the maxillofacial shape caused by surgical trauma, language, hearing and other dysfunctions. And the psychological barriers that patients form in social interactions.

Cleft palate symptoms Common symptoms Rabbit lips and nasal cavity can not be closed... Cleft palate dystrophic children with bone defects, cough, soft palate, scars, swallowing difficulties

Usually splitting can be divided into four types:

1 soft cleft palate, no cleft lip.

2 soft and hard cleft palate, often complicated by unilateral incomplete cleft lip.

3 Unilateral cleft palate, from the uvula to the incisor, obliquely to the outside, to the lateral incisors all split, the alveolar processes on both sides are separated by the mucosa, often with a unilateral complete cleft lip.

4 bilateral complete cleft palate, often coexisting with bilateral complete cleft lip, the fissure is split to the side at the lateral incisor, and the lower end of the nasal septum is free.

Clinically, the three types of cleft palate are the most common, the four are the least common, and the newborns or infants with severe cleft palate often have sucking and swallowing dysfunction, causing dystrophies and coughing during sip, aspiration pneumonia, and children There are often obvious open nasal or ambiguous words.

Splitting check

1. Visual examination: The uvula is fissure, and the soft palate is membranous or sulcus-like. There are longitudinal muscle bulges on both sides of the midline, and small pupils are sometimes seen on the midline.

2, x tablets: the nose after the split ends, soft sputum short, sore throat closure.

3, finger palpation: can detect the extent of hard palate defects.

Cleft palate diagnosis

The main points of cleft palate are the following distinctions:

(1) Soft cleft palate: only soft palate is split, sometimes only limited to palate. Regardless of the left and right, generally without cleft lip, clinically more common in women.

(2) Incomplete splitting: also known as partial splitting. The soft palate is completely ruptured with a partial hard cleft palate; sometimes accompanied by a unilateral incomplete cleft lip, but the alveolar process is often intact. This type also has no left and right points.

(3) Unilateral complete cleft palate: the fissure from the sag to the incisor is completely ruptured, and obliquely outward to the alveolar process, connected to the alveolar cleft; the contralateral fissure edge is connected to the nasal septum; the alveolar cleft is sometimes fissure Disappearing only cracks, sometimes cracks are wide; often accompanied by ipsilateral cleft lip.

(4) bilateral complete cleft palate: often coincides with bilateral cleft lip, the fissure is in the temporomandibular part, each side is obliquely split, reaching the alveolar process; the nasal septum, anterior maxillary process and anterior lip are isolated from the center.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.