Cleft Lip and Palate
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CLEFT LIP & PALATE(LABIOPALATOSCHIZIS)
Fadhlina Muharmi Harahap0708112239
EMBRIOLOGI & DIAGNOSIS
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Etiologi
• Defisiensi Asam folat, Zn, B6, Vit C pada waktu hamil
• Radiasi• Terjadi trauma pada kehamilan TM I• Infeksi pada ibu mempengaruhi janin infeksi
Rubella, Sifilis, Toxoplasmosis, Chlamydia• Pengaruh obat teratogenik jamu & kontrasepsi
hormonal. Akibat toksisitas selama kehamilan kecanduan alkohol, terapi penitonin
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Etiologi
• DNA studies– transforming growth factor-a (TGFA)
nonsyndromic cleft lip & palate (NCLP) white population.– TGFB3 a strong candidate for clefting in
humans–Other candidate genes NCLP D4S192,
RARA, MTHFR, RFC1, GABRB3, PVRL1, IRF6.
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Embriologi
• Kepala :– Mesoderm lempeng paraksial (somit &
somitomer)– Mesoderm lempeng lateral– Mesoderm krista neuralis– Ektoderm yang menebal plakoda ektoderm
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5 minggu
Prominensia frontonasalis
Lubang Hidung
Tonjol maksila
Tonjol mandibula
Tonjol hidung medial
Mata
Tonjol hidung lateral
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Bangunan yang ikut membentuk wajah….
Prominensia Bangunan yang terbentuk
Frontonasal Dahi, jembatan hidung, tonjol hidung medial & lateral
Maksila Pipi, bagian lateral bibir atasMedial nasal Filtrum bibir atas, lengkung & ujung
hidungLateral nasal Alae nasiMandibula Bibir bawah
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Patofisiologi
• Foramen incisivum depan atau belakang?• Labioskizis tidak menyatunya sebagian /
seluruh tonjol maksila & tonjol hidung medial pada satu atau kedua sisi.
• Palatoskizis tidak menyatunya lempeng-lempeng palatina ??? ukuran lempeng kecil, lempeng gagal terangkat, hambatan proses penyatuan, lidah gagal turun
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• Labioskizis lebih berat lebih dalam bentuk celah rahang atas maksila terbelah di antara gigi seri lateral & gigi taring kadang meluas ke foramen incisivum
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Kelainan jantung sering disertai cacat kraniofasial ??
• Kelainan pada pembentukan bantal – bantal endokardium malformasi jantung, termasuk ASD, VSD, TGA & TOF
• Sel yang mengumpul di bantal konotrunkal sel-sel krista neuralis
• Sel-sel krista neuralis kepala & leher
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Diagnosis
• Gejala :– Pemisahan langit-langit– Pemisahan bibir– Pemisahan bibir & langit-langit– Infeksi telinga berulang– BB tidak bertambah– Bayi regurgitasi nasal ketika menyusui
keluar dari hidung– Sulit bicara
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• Post natal– ciri fisik spesifik
• Pre natal– USG
• Medical tests may be done to rule out other possible health conditions
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TERI
MAKASIH