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Cleft lip

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction The cleft lip is commonly called "rabbit lip", which means that the upper lip is cracked, which is a kind of congenital malformation. Cleft lip is the most common congenital malformation in the oral and maxillofacial region, often associated with cleft palate. Normal fetuses begin to fuse with some embryonic processes to form a face after the fifth week. If they fail to develop normally, they can deform, including cleft lip. According to previous surveys, the prevalence of cleft lip and palate in newborns is approximately 1:1 000, but the information is not exactly the same everywhere. According to the results obtained by China Birth Defects Testing Center from 1996 to 2000, 2 265 cases of cleft lip and palate were detected in 2,218,616 perinatal children in 31 provinces and cities nationwide, and the prevalence rate was 1.625:1 000. . The above data indicate that the prevalence of cleft lip and palate in China is on the rise, similar to recent foreign reports. According to statistics, the ratio of male to female in cleft lip and palate is 1.5:1, more men than women.

Cause

Cause

Reasons for the rabbit's lips:

At the 4th week of the onset of the embryo, a middle nasal process, two lateral nasal processes, and upper and lower jaw processes from the first zygomatic arch were formed around the mouth. Later, the maxillary processes on both sides merge with the mid-nose process to form the upper lip. If the fusion disorder forms a cleft lip, if both sides are not fused, it will form a bilateral cleft lip.

The exact cause and pathogenesis of developmental and fusion disorders are not fully understood. According to a large number of experimental studies and epidemiological survey results, it may be caused by multiple factors rather than a single factor. In a nutshell, it can be divided into two aspects: genetic factors and environmental factors, and is related to factors such as nutrition, genetics, infection, and endocrine.

Genetic factor

Patients with cleft lip can be found to have similar malformations in their immediate or collateral relatives, and it is therefore believed that cleft lip deformity has a certain relationship with heredity. Epidemiological investigations have shown that in patients with cleft lip deformity in the immediate family, the incidence of cleft lip in the offspring is higher than that in the relatives. Genetic studies also suggest that cleft lip is a polygenic hereditary disease.

2. Environmental factors

Mainly refers to the environment of embryo growth and development, the entire physiological state of the mother constitutes the environmental conditions of embryo development. Therefore, during the first three months of pregnancy, when the physiological state of the mother is invaded or interfered, it may affect the growth and development of the embryonic maxillofacial region.

(1) Nutritional deficiency

In the experimental animal research, it was found that mice lacking food components such as vitamin A, B2 and folic acid can produce deformities such as cleft lip, and whether humans will also cause congenital malformation due to lack of such substances is not very clear. Therefore, nutritional deficiencies in early pregnancy may be one of the causes of the disease.

(2) infection and injury

If the mother suffers some kind of damage in the early stage of pregnancy, especially the damage of the uterus and its adjacent parts, such as improper incomplete abortion or unscientific drug abortion, it can affect the development of the embryo and cause deformity. The mother's viral infections such as rubella can also affect the development of the embryo and become a possible cause of cleft lip.

(3) Endocrine effects

Infants born in early pregnancy have a congenital malformation in infants born after hormone therapy. In addition, in the investigation of the family history of children with cleft lip, some mothers have also found various obvious traumatic factors in the early stage of pregnancy. It is inferred that there may be a stress reaction resulting in an increase in the secretion of adrenocortical hormone in the body. Inducing congenital malformations.

(4) Drug factors

Most drugs enter the embryo through the placenta after entering the mother. Some drugs may affect the development of the embryo and cause malformations. Currently known anti-tumor drugs (such as cyclophosphamide, methotrexate, etc.), anticonvulsant drugs (phenytoin), antihistamines, and Minkjing and some of them for treating vomiting. Some sleeping pills (such as thalidomide) can cause fetal malformations.

(5) Physical damage

For example, during fetal development, frequent exposure to radiation or microwaves may affect the growth and development of the fetus and become a possible cause of cleft lip.

(6) Tobacco and alcohol factors

In the early pregnancy, a large number of cigarettes and alcohol abuse, the incidence of cleft lip in children is higher than that of women who are not interested in smoke-free wine, and thus is one of the possible factors leading to cleft lip in the fetus.

Examine

an examination

Related inspection

X-ray cephalometric measurement of maxillofacial examination of head and face palpation

Examination and diagnosis of the rabbit's lips:

There are cracks in the lips of patients with cleft lip, unilateral or bilateral, often directly below the center of one side of the nostrils, the size varies, the larger can reach the nostrils, and often accompanied by the collapse of the nose. Cleft lip and palate hinders the appearance, can also cause suction dysfunction, incisor development deformity, prominent, anterior alveolar cleft. It affects the feeding, and it is easy for the sick child to inhale into the respiratory tract when eating milk, causing bronchitis and pneumonia. Because it can't be properly breast-fed, malnutrition and various nutritional disorders can occur in children who have been sick for a long time. Serious people are even life-threatening. The lip is one of the organ organs. When the cleft lip disease is spoken, the words are unclear and affect the pronunciation.

Diagnosis and judgment can be made according to the signs of the child and the clinical manifestations of the rabbit's lips.

Diagnosis

Differential diagnosis

Differential diagnosis of rabbit lips:

Nasal and labial groove deepening: Nasal and labial groove is a surface sign of the human face. Everyone has it. The depth varies with individual differences. It gradually deepens with age, and generally begins to deepen at the age of 25. It will gradually increase as the tissue of the face sags. The nasolabial fold is a shallow groove from the sides of the nose to the outside of the mouth. The upper end starts from the inner upper part, then goes outwards and downwards, and then descends between the buccal and lip, so it is commonly called "lip groove". Children and young people only have this ditch when they smile, and the ditch is also obvious when the face is aging. Nasolabial fold is one of the important morphological features of facial aging, and it is also a sign of aging in the cheeks and lips. Morphologically, it is a concave wrinkle that is excessive in the skin of the cheeks. After the nasolabial fold appears, the tissue of the face appears to be more sagging and more aging.