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Last reviewed: 18 Mar 2025
Last updated: 20 Apr 2023

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • bilateral cleft lip ± palate
  • unilateral cleft lip ± palate
  • isolated cleft palate
  • microform cleft lip
  • isolated sub-mucous cleft palate
  • positive antenatal ultrasound

Other diagnostic factors

  • difficulty feeding
  • poor weight gain
  • airway obstruction

Risk factors

  • genetic predisposition
  • anticonvulsant drugs
  • maternal tobacco use
  • maternal alcohol consumption
  • folic acid deficiency

Diagnostic investigations

Investigations to consider

  • auditory brain stem response (ABR) test
  • vertebral spine x-rays
  • renal ultrasound
  • fluorescence in situ hybridisation (FISH)
  • ophthalmic examination

Treatment algorithm

Contributors

Authors

Travis T. Tollefson, MD, MPH, FACS
Travis T. Tollefson

Professor and Director

Facial Plastic and Reconstructive Surgery

Otolaryngology - Head and Neck Surgery

Cleft and Craniofacial Team

University of California Davis

Sacramento

CA

Disclosures

TTT has received an honorarium and reimbursement for travel by the AO Foundation for teaching on a facial trauma course. TTT serves on the American Board of Otolaryngology and the American Board of Facial Plastic and Reconstructive Surgery, and receives a royalty from Thieme publishing for the textbook Complete Cleft Care. TTT is an author of studies referenced in this topic. TTT serves as editor-in-chief of the journal ‘Facial Plastic Surgery and Aesthetic Medicine’.

David A. Shaye, MD
David A. Shaye

Instructor

Facial Plastic and Reconstructive Surgery

Massachusetts Eye and Ear

Harvard University

Boston

MA

Disclosures

DAS has received an honorarium and reimbursement for travel by the AO Foundation for teaching on a facial trauma course.

Peer reviewers

Jordan N. Halsey, MD

Pediatric Plastic and Craniofacial Surgeon

Assistant Professor of Plastic Surgery

Johns Hopkins University

Assistant Professor of Plastic Surgery

University of South Florida

Tampa

FL

Disclosures

JNH declares that he has no competing interests.

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