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DEFINITION

A cleft is a birth defect that occurs when the tissues of


the palate of the fetus do not fuse very early in
pregnancy.
A cleft palate is an opening in the roof of the mouth.
EPIDEMIOLOGY

Gender distribution
Racial distribution

Cleft
palate or
without male
cleft lip
Cleft
palate
female
Familial distribution

Family members with Probability of subsequent Probability of subsequent


Cleft Palate child with cleft palate (%) child with cleft Lip +/-
cleft palate (%)

• One affected child only 2 4


• One affected parent only 2-4 2-4
• One affected child and a
positive family history
(with normal parent) 7 7
• One affected parent and
one affected child 15 14-17
A. Genetic
- is probably a ETIOLOGY
single major
gene
autosomal
recessive trait
with other B. Environment
minor genes
contributing 1. The exact role of any
environmental factor
is not clear
2. Alcohol
- is probably 3. Smoking
polygenic with 4. Many teratogenes
multiple major and 5. Folic acid and vit B6
minor genes intake during preg-
contributing nancy may reduce
Efek terhadap fungsi
Menghisap&
makan :
lubang + Hidung : mukosa Pendengaran :
sebabkan Bicara : terkontaminasi kegagalan
masuk ke sukar sebut mikroorganisma drainage &
hidung/laring b,d,k,p,t,g ventilasi tuba
dari mulut eustachia

To facilitate normal speech and hearing without significantly


affecting the facial growth of the child
Speech
Closure of the Hearing
cleft,performance

Facial, teeth Sucking & eat


growth without nasal
regurgitation
Soft Vomer
palate flap
Alveolar
cleft
repair
Hard
palate
cleft 1. Straight-line repair
2. Double Z-plasty
(Furlow)

1. Von Langenbeck Repair


2. V-Y pushback (Veau-
Wardill-Kilner)
Complication

A. Fistulae
B. Midfacial growth
• occur in > 50% depent
problem
on preop. Anatomy
• Multifactorial
and repair technique C. Airway obstruction
• Have inherent facial
• in wide and bilateral
growth impairment
clefts • Occur secondary
• Lip and alveolar post op bleeding
• In hard palate
• With at single layer
repair significantly • Include pharyngeal
affect facial growth flaps
closure
• Extent and timing of Should be monitored
palate repair
Problema

Ketidakmampuan menghisap pembuatan obturator shg


melekat di palatum dan menutup celah  proses menelan lebih
baik, pertumbuhan tl alveolus lebih baik

By a team composed of plastic surgery, speech pathologist,


orthodontist, audiologist and psychologic

Palatoplasty dikerjakan rentang usia 18 bulan sampai 2,5


tahun, dimana anak belum berbicara penuh

Komplikasi dan perawatan post op palatoplasty