Learn about cleft lips and related conditions in pediatrics. Dr.David C. Hoffman - Oral & Maxillofacial Surgery School of Dentistry: NY Univ.- College of Dentistry Residency :Oral & Maxillofacial Surgery Univ. Texas Health Science Center Parkland...
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Cleft Lips/Palate – Related Conditions Male1: Okay, if the kid is boy and obviously, it is an obvious thing of his lip, on the doctor’s examination feels the __ is a whole __, the palate. What should be done when the kid is born, because first thing, have this fed is that right? Male2: Well, a baby born with a cleft lip has a couple of immediate needs and I see babies born right away with a cleft lip. I have seen them within there first 24 hours because usually the neonatal is toward the doctors who take care of babies who are just born only and I make an attempt to see the baby and the parents. The immediate needs are that feeding is number one. The baby can not, as you can imagine could have a good suction on the mother’s nipple or in a bottle and so there are special bottles made available for cleft feeding and your special techniques that usually the nurses could show the mother how to do it. But that is the most immediate problem and often for the first 24 to 48 hours a day, the baby has to __ feeding to place to regain enough strength, to--- Male1: So nutrition is the key thing, to keep the baby stable. In the __ through a concern __ everything is going well in the body too Male2: That is really a good question. Cleft lips and cleft palates are the number one birth defect and you might think that heart form this one, number one but cleft lips have a little higher incidence. The incidence in metropolitan areas of United States is about 1 in 500 to 1 in 700 babies are born with a real cleft lip or cleft palate. Now that is a red flag because you immediately have to think of other syndromes or other congenital deformities. There are, the children should __ 50 in general deformities that are associated with fully __ cleft lip that means that kids born with other body malformations or defects are born with also cleft lips. So you have to think of right away that those kids maybe have it a sonogram or an ultrasound of their heart to make sure they have no heart defects, and worry about other chromosomal defects and appropriately most babies born with a cleft lip often see a geneticist (voice overlap) Male1: Are there any common genetic diseases that are associated with it. Male2: Well, the most common thing that you are going to see is heart defect per se. you have to make sure that there is no underlying heart problems. And mostly __ would pick that up right away. (Voice overlap). Male1: We trapped the kidney stone. Male2: Yes, that was headed that the kidneys with problem, the heart. The most common syndromes you are going to see with cleft or other deformities of the face, the one that we think about frequently is a disease or a syndrome called “Golden Heart” or a hemifacial microsomia. Now that is the situation where babies are born with, there are problem with there ear. There ear does not develop right. There jaw does not develop right and they have a little bit of a funny look to them. Not a very common one is called Velo-Cardial-Facial syndrome (VCFS). In these instances, the baby is born with a cleft palate, a heart defect, and they also have learning disabilities and speech problems and there we know that we can test for this. That they have a chromosome defect and that they call it a 22-chromosome and they have to look at all of the lesions or something. Little thing is missing and the interesting thing here is that you may see the baby along with a very minor cleft palate but when the baby has, or as the baby begins to talk, they have something a little bit of with their speech but once you do the chromosome test, and it is positive for the problem you immediately have to consider underlying heart defects and you have to consider that you are going to have some type of learning defect and also you have something little bit more sophisticated if got an artery in the back of their throat that could be in the wrong place. The carotid artery could be in the wrong place and you have to know that because when you

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