Congenital Anomalies of The Face

Dr Hatem El GoharyLecturer of General Surgery

Cleft lip and palate

•cleft lip alone: 15%; •cleft lip and palate: 45%; •isolated cleft palate: 40%.

AETIOLOGY

•Genetic.•Maternal anti-epileptic drugs.

Problem

•Speech.•Feeding.•Hearing.

Types(a) Unilateral cleft lip with alveolar involvement;(b) bilateral cleft lip with alveolar involvement ;

(c) unilateral cleft lip associated with cleft palate ;(d) ; bilateral cleft lip and palate ) (e c left palate

only.

Cleft lip (unilateral or bilateral)

•The abnormalities in cleft lip are the direct result of disruption of the muscles of the upper lip and nasolabial region.

•Involving the external nasal cartilages, nasal septum and anterior maxilla (premaxilla).

Cleft palate

•Cleft palate results in failure of fusion of the two palatine shelves.

•Types: -soft palate only - soft and hard palate.

TREATMENT

Surgical Repair

•3-6 months in cleft lip (One operation).•6-18 months in cleft palate.(one or two operations).

Congenital anomalies of The Urinary system

WILMS’ TUMOR (Nephroblastoma)

•most common childhood abdominal malignancy.

•Caused by genetic abnormalities.

DiagnosisSymptoms• Abdominal pain.• Hematuria. • Fever.• Respiratory symptoms e.g.cough and dypsnea

(due to lung metastasis).

Signs• Abdominal mass.• Varicocele.

Investigations•Chest x ray to detect lung metastasis.•Abdominal Ultrasound Tumour of the

kidney.•CT and MRI To detect relation of the

tumour to the surrounding and invasion of the IVC.

Treatment:

Nephrectomy

Chemotherapy + Radiotherapy.

Hypospadias

Definition:Congenital abnormal opening of the urethra in the underside of the penis.

Characterized by The dorsal Foreskin is hooded

Aetiology: Failure of complete urethral tubularisation in the male fetus.

Types:•First degree: Glanular(distal)•Second dgree: Mid-shaft.•Third degree: Scrotal or perineal.

Treatment

•Avoid circumcision.

•Surgical repair Before the age of 2 years.