Front, maxillary, mandibular processes form the face, neural crest origin, left left lip due to failure of fusion of median nasal and maxillary processes

Palatal process from maxillary processes fuse with premaxilla and nasal septum from anterior to posterior

Bifid uvula, zona pellucida, palpable notch hard palate

Cleft Palate coordinator
Geneticist

Feeding,
Surgical preparation,
Auditory brain stem Response

Lip Repair
Consideration of typanostomy tubes

Speech and Language education
Palate Repair
Behavioral Audiometry
Tympanostomy Tubes
Evaluation of primary dentition

Team Reassessment
Possible secondary surgery for speech

Consider lip and nose revision
Team Conference if Necessary
Psychosocial

Characteristics: Micrognathia, Glossoptosis, U Shaped cleft palate

Velocardiofacial syndrome: Overt cleft palate, submucous cleft palate or weak palate

Need to feed in upright posiotion to diminish nasal regurgitation, frequenbt burning, breast feeding is difficult, special squeenze bottle and nipple smyptoms can be used

Maxillary midline deviated to unaffected side, nasal septum deviated to unaffected side, flat alar cartilage, short columella

Improved Feeding, tongue position, symmetry of alar domes

Reduced tension on lip close, stable platform for nasal repair, realignment of alveolar segments, reduction in need for secondary alveolar bone graft

Air is absorbed by middle ear mucosa, negative middle ear pressure, sucks fluid out of mucosa, effusion and development of chronic otitis media

Auditory Brainstem Response: Determine if tubes needed

Treatment with: Speech therapy, nasopharyngoscopy, plastic surgery

Missing, malformed, malpositioned or supernumary teeth

Goals: Provision of adequate bone to support adjacent teth and permit eruption of canine and/or lateral incisor, provide support for lateal of nose, provide suitable bony morphology on the cleft side, establihs fucntional airway on cleft side