💡 Clefts of the Lip & Palate – Concise Q&A

What is a cleft?

Opening from failed fusion in fetal development.

What areas can be affected?

Lip, alveolus, hard or soft palate.

Can clefts be acquired?

Yes, from trauma or surgery.

Cleft lip involves?

Gap between lip and alveolar ridge.

Cleft palate involves?

Opening between oral and nasal cavities.

What affects cleft variation?

Type, length, and width.

When does the primary palate form?

Week 7.

Structures in the primary palate?

Lip and alveolus.

When does the secondary palate form?

Week 9.

Structures in secondary palate?

Hard palate, soft palate, uvula.

What is a complete cleft?

Extends to the incisive foramen.

What is an incomplete cleft?

Stops before the incisive foramen.

What causes clefts?

Neural crest fusion failure.

Are clefts multifactorial?

Yes, genetic and environmental.

Recurrence risk in U.S.?

3–5%.

Highest cleft incidence?

Indigenous Americans.

Lowest cleft incidence?

Africans.

Environmental risks?

Smoking, alcohol, drugs, infection, radiation.

Maternal risks?

Poor diet, obesity, diabetes, uterine crowding.

👄 Primary Palate Clefts

Structures involved?

Lip and alveolus.

Microform cleft?

Small notch or scar.

Unilateral incomplete?

One-sided, partial cleft.

Bilateral incomplete?

Partial clefts on both sides.

Unilateral complete?

Full cleft into one nostril.

Bilateral complete?

Full cleft across both sides.

Structural effects?

Flat nose, short columella, dental issues.

Functional effects?

Artic errors, nasal resonance.

🦷 Secondary Palate Clefts

Structures affected?

Hard and soft palate, uvula.

Incomplete cleft palate?

Partial opening.

Complete cleft palate?

Full gap to incisive foramen.

Bilateral complete cleft lip/palate?

Entire lip and palate separated.

Pierre Robin cleft shape?

Wide, bell-shaped.

Muscle defect name?

Cleft muscles of Veau.

Structural effects?

Abnormal muscle and septum.

Functional effects?

VPI, feeding issues, ear problems.

🎭 Submucous Cleft Palate

What is it?

Hidden cleft under intact mucosa.

Classic triad?

Bifid uvula, zona pellucida, notch.

Zona pellucida?

Blue midline on velum.

Phonation sign?

Upside-down “V.”

Overt cleft?

Visible orally.

Occult cleft?

Hidden; seen nasally.

Functional problems?

VPI, nasal leak, ear fluid.

🗣️ SLP Clinical Notes

Common speech signs?

Hypernasality, nasal emission, glottal stops.

Why compensatory errors?

Low oral pressure from VPI.

Feeding issues?

Poor suction, nasal regurgitation.

Ear issues cause?

Eustachian tube dysfunction.

Team members?

SLP, ENT, surgeon, audiologist, ortho, psych.

🧠 Mnemonics

Primary vs Secondary Palate?

“Lip Leads, Palate Proceeds.”

Submucous triad?

“B-Z-N.”

Affected areas summary?

Feed, Speak, Hear.