Cleft lip and palate — formative SAQs

SAQ 1 (10)

A newborn is diagnosed at the postnatal check with a complete unilateral cleft of the lip and palate on the left side. The baby weighs 3.2 kg, is otherwise well, and the mother is anxious about feeding. The newborn hearing screen refers on both sides. ^[2]

a) State the Veau grade of this cleft, and explain the embryology that produced it. (3 marks) ^[1]

b) Describe the feeding technique you would teach the mother on day one, naming the type of bottle or teat and the feeding position, and explain why a standard nipple or the breast is unlikely to succeed. (3 marks) ^[7]

c) Outline the staged surgical timeline from now through to adolescence, naming the age of the lip repair, the palatoplasty and the alveolar bone graft. (2 marks) ^[2]

d) Explain the cause of the near-universal otitis media with effusion in cleft palate, and state the timing and the purpose of the first ventilation tubes (grommets). (2 marks) ^{[10] [11]}