Goals of Reconstruction
- Providing adequate bony matrix for the developing teeth
- Closure of any residual oronasal fistulas
- Create alveolar ridge continuity
- Improve bony support for the nasal base on the cleft side
- Bilateral cleft palate – stabilize mobile premaxillary segment
Incidence of Cleft Lip & Palate
- Cleft palate: F > M (3:2)
- Cleft lip: male on left
Rule of 10’s
- 10 weeks of age
- Weighs 10 lbs
- Serum Hg of 10mg/dL
Isolated Cleft Palate
- Isolated cleft palate: underlying syndromal association
- Stickler syndrome (type of Robin sequence): most common; multiple systemic anomalies, principally including articular, ophthalmologic (high grade hyopia and retinal detachment), and facial findings (depressed nasal bridge, midfacial hypoplasia, micrognathia, cleft palate)
- Velcardiofacial syndrome (q22 deletion): cleft palate, cardiac anomalies, mental retardation, learning disabilities, internal carotid deviation, micrognathia, narrow palpebral fissure, microcephaly; ring chromosome anomaly
- Van der Woude syndrome: clefting and lower lip pits
