What is cleft?
Cleft is synonymous with SPACE; with clefts it is usual to indicate a type of tissue cracking that is genetically determined or in any case influenced by familiarity; during embryonic development, those affected by cleft do not reach the continuity of one or more areas or segments which therefore appear interrupted and / or incomplete due to lack of fusion of the two tissue heads.
Types of clefts
In simple terms, cleft is a type of malformation that differs according to the affected region; the most common forms of cleft are:
- Cheiloschisis or cleft lip: more commonly referred to as cleft lip; it is a crack between the upper portion of the mouth and the lower portion of the nose. Cheiloschisis can be mild, affecting only the soft tissues of the lip, or more severe and also affecting the bone / cartilage floor of the nasal cavities and / or the dentition; severe cheiloschisis causes complications of swallowing with passage of the bolus or residues of it through the respiratory tract, increasing the risk of bronchopneumonia (especially in the infant and child). The treatment of cleft cheilos is surgical and ranges from a simple facial plasty to a real maxillofacial surgery one or two months after birth.
- Cleft palate: it is a malformation of the palate; it presents as a spacing of the anterior portion of the hard palate and is often associated with cleft lip. In the most severe forms, the entire soft palate, the palatine vault, the alveolar portion of the palate and the uvula itself are compromised; the cleft palate, in addition to favoring bronchopulmonary infections by aspiration of the food bolus, can favor a serious alteration of the ability to speak. Plastic surgery is essentially applied within the first month of life.
- Rachischisi: also called spina bifida; it is a malformation of the rachis and spinal cord in which the canal remains incomplete and favors the escape of medullary hernias. Cracking can also affect nerve tissue (cleft neurosis), bone and the overlying skin region with exposure of the medullary canal (spina bifida cystic); if the skin is intact and appears as a dimple covered with hair, spina bifida is defined as occult.
NB. When the malformation affects the whole spine, it is called rachischisi.
The symptomatology depends on the severity of the general condition and occurs in proportion to the nerve damage; if spina bifida is occult, the symptoms are absent. In severe cases, surgery is essential but only palliative. - Cleft Neuroschisis: as anticipated, it is a crack in the nervous tissue; it can be associated with spina bifida affecting the spinal cord or extend beyond, up to the cerebellum. Cleft neuro is extremely disabling and in severe cases involves paresis of the limbs and faecal and / or urinary incontinence. Surgery for cleft neuro is applied above all in cases of cystic spina bifida towards which it plays a palliative role (exposure of the medullary canal) in order to reduce the infectious risk.
