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Also known as: '''''Congenital oronasal fistula — Palatoschisis
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Also known as: '''''Congenital Oronasal Fistula — Palatoschisis
[[Image:Cleft-palate.gif|right|thumb|300px|<small><center>A congenital cleft palate defect (Courtesy of Alun Williams (RVC))</center></small>]]
==Introduction==
[[File:Cleft lip puppy.jpg|right|thumb|300px|Primary cleft palate with associated cleft lip]]
[[File:Cleft palate 2.jpg|right|thumb|300px|Secondary cleft palate]]
An abnormal communication between the [[Nasal Cavity - Anatomy & Physiology| nasal]] and [[Oropharynx - Anatomy & Physiology| oral]] cavities involving the [[Soft Palate| soft palate]] , [[Hard Palate| hard palate]], premaxilla and or [[Lips|lip]] . Abnormalities arise during foetal development where there is incomplete closure of the primary palate, secondary palate or both.
An abnormal communication between the [[Nasal Cavity - Anatomy & Physiology| nasal]] and [[Oropharynx - Anatomy & Physiology| oral]] cavities involving the [[Soft Palate| soft palate]] , [[Hard Palate| hard palate]], premaxilla and or [[Lips|lip]] . Abnormalities arise during foetal development where there is incomplete closure of the primary palate, secondary palate or both.
The primary palate develops into the premaxilla and lip. If closure is not complete this will result in a primary palate or cleft lip (harelip).
The primary palate develops into the premaxilla and lip. If closure is not complete this will result in a primary palate or cleft lip (harelip).
Possible causes may include administration of [[Antifungal Drugs#Griseofulvin|griseofulvin]] to queens during pregnancy, certain viral infections or ingestion of toxic plants.
Possible causes may include administration of [[Antifungal Drugs#Griseofulvin|griseofulvin]] to queens during pregnancy, certain viral infections or ingestion of toxic plants.
==Aetiology==
The facial part of the dorsal surface of the skull is formed by parts of the [[Skull and Facial Muscles - Anatomy & Physiology|frontal, nasal, maxillary, and incisive bones]]. Problems, such as a cleft palate, can arise if the fusion of these bones does not occur properly. It is also important to note that each quadrant of the skull and jaw develops independent of the other three quadrants. If there is an abnormality on one side, it does not necessarily mean the other side is also affected.
'''Primary cleft palate''': defect between the incisive bone and maxilla. This type of cleft is often associated with a harelip or cleft lip.
'''Secondary cleft palate''': defect in the maxilla that may or may not extend to involve the soft palate.
==Signalment==
==Signalment==
==Diagnosis==
==Diagnosis==
===History and Clinical Signs===
===History and Clinical Signs===
Failure to thrive with signs such as nasal discharge, nasal milk regurgitation, gagging, coughing or sneezing during nursing, and respiratory infection due to aspiration pneumonia or rhinitis.
Failure to thrive with signs such as nasal discharge, nasal milk regurgitation, halitosis, gagging, coughing or sneezing during nursing, and respiratory infection due to aspiration pneumonia or rhinitis.
Diagnosis is made on physical exam. A cleft lip can be easily identified, however, a full oral examination is needed to diagnose incomplete closure of the premaxilla, hard and soft palate.
Diagnosis is made on physical exam. A cleft lip can be easily identified, however, a full oral examination is needed to diagnose incomplete closure of the premaxilla, hard and soft palate.
===Closure of Primary Clefts===
===Closure of Primary Clefts===
Often very difficult to correct surgically, and requires planning and multiple surgeries.
Often very difficult to correct surgically, and requires planning and often multiple surgeries.
===Closure of Secondary Clefts===
===Closure of Secondary Clefts===
====Soft Palate defects====
====Soft Palate defects====
An overlapping flap technique, flaps from the hard palate and nasopharangeal mucosa flaps can be used to repair soft palate deformities.
An overlapping flap technique, flaps from the hard palate and nasopharangeal mucosa flaps can be used to repair soft palate deformities. It is important to reduce tension on suture lines, preserve the connective tissue and vascular supply and have good apposition of tissue to promote rapid healing of the wound.
Post operatively patients should be fed via a tube to prevent trauma to the surgical site and to maintain nutritional intake. Dehiscence and recurrence can occur following movement, tension and growth.
Post operatively patients should be fed via a tube to prevent trauma to the surgical site and to maintain nutritional intake. Dehiscence and recurrence can occur following movement, tension and growth.
{{Learning
{{Learning
|flashcards = [[Oral_Cavity_Flashcards_-_Pathology|Oral Cavity Pathology Flashcards]]<br>[[http://en.wikivet.net/Equine_Internal_Medicine_Q%26A_10]]
|Vetstream = [https://www.vetstream.com/canis/Content/Disease/dis00692.asp, Harelip]<br>[https://www.vetstream.com/canis/Content/Disease/dis00691.asp, Cleft lip and palate]<br>[https://www.vetstream.com/canis/Content/Technique/teq00674.asp, Cleft palate repair]
|flashcards = [[Oral_Cavity_Flashcards_-_Pathology|Oral Cavity Pathology Flashcards]]<br>[[Small Animal Soft Tissue Surgery Q&A 01]]
|literature search = [http://www.cabdirect.org/search.html?start=0&q=%28%28od%3A%28dogs%29%29%29+AND+%28%28title%3A%28%22Cleft+Palate%22%29%29%29 Cleft palate in Dogs publications]
|literature search = [http://www.cabdirect.org/search.html?start=0&q=%28%28od%3A%28dogs%29%29%29+AND+%28%28title%3A%28%22Cleft+Palate%22%29%29%29 Cleft palate in Dogs publications]
[http://www.cabdirect.org/search.html?q=%28%28od%3A%28cattle%29+OR+od%3A%28sheep%29+OR+od%3A%28goats%29%29%29+AND+%28%28title%3A%28%22Cleft+Palate%22%29%29%29 Cleft palate in Farm Animals publications]
[http://www.cabdirect.org/search.html?q=%28%28od%3A%28cattle%29+OR+od%3A%28sheep%29+OR+od%3A%28goats%29%29%29+AND+%28%28title%3A%28%22Cleft+Palate%22%29%29%29 Cleft palate in Farm Animals publications]
}}
}}
==References==
==References==
Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition) Mosby Elsevier
Fossum, T. W. et. al. (2007) '''Small Animal Surgery''' (Third Edition) ''Mosby Elsevier''
Gilson, SD (1998) '''Self-Assessment Colour Review Small Animal Soft Tissue Surgery''' '' Manson''
Merck & Co (2008) '''The Merck Veterinary Manual''' (Eighth Edition) ''Merial''
{{Lisa Milella reviewed
|date = 13 August 2014}}
{{Waltham}}
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[[Category:Nasal Cavity - Developmental Pathology]]
[[Category:Nasal Cavity - Developmental Pathology]]
[[Category:Respiratory System - Developmental Pathology]]
[[Category:Respiratory System - Developmental Pathology]]
[[Category:Oral Diseases - Cattle]][[Category:Oral Diseases - Horse]][[Category:Oral Diseases - Goat]][[Category:Oral Diseases - Pig]][[Category:Oral Diseases - Sheep]]
[[Category:Oral Diseases - Cattle]][[Category:Oral Diseases - Horse]][[Category:Oral Diseases - Goat]][[Category:Oral Diseases - Pig]][[Category:Oral Diseases - Sheep]]
[[Category:Oral Diseases - Cat]][[Category:Oral Diseases - Dog]]
[[Category:Oral Diseases - Cat]][[Category:Oral Diseases - Dog]]
[[Category:Expert_Review - Farm Animal]][[Category:Expert Review - Small Animal]][[Category:Expert Review - Horse]]
[[Category:Developmental Dental Conditions]]
[[Category:Lisa Milella reviewed]]
[[Category:Waltham reviewed]]