How I Treat... Congenital Cleft Palate

INTRODUCTION

Congenital defects of the formation of lip and palatal structures may be inherited or result from an insult during fetal development (intrauterine trauma or stress). In most cases the cause is an intrauterine insult, and brachycephalic dog breeds are at higher risk. 1 Owners should be warned that multiple procedures might be required to completely close a cleft.

CLEFT LIP

This congenital defect of the primary palate appears as defect of the lip +/- most rostral hard palate and could be associated with abnormalities of the secondary palate. Unilateral defects occur more commonly on the left side. Cleft lips rarely result in clinical signs beyond mild local rhinitis, and repair may be performed for esthetic reasons. 1 Simple sliding procedures rarely are successful because there is no connective tissue bed to support the flaps. The most rostral hard palate and the floor of the nasal vestibule are reconstructed by creating overlapping and advancement, rotation or transposition flaps of both oral and nasal tissue or flaps that are harvested from oral soft tissue only. Removal of one or more incisors and also the canine tooth on the affected side several weeks prior to definitive surgery will facilitate flap management. Lip repair is completed by reconstructive cutaneous surgery to provide symmetry. […]