Talk:Cleft

From Wikipedia, the free encyclopedia

Contents 1 Nose 2 Wives' tale 3 CleftClub SPAM 4 Cosmeric murder, as in cleft-based abortion 5 merger suggestion 6 Talk:Cleft palate 6.1 Causes: relations to drugs, alcohol etc instead of genetics 7 Joaquin Phoenix 8 Causes of Cleft Lip/Palate 9 Submucosal Cleft Palate - or Hidden Cleft Palate 10 Cleft lip and palate in the dog 11 Common treatment schedule 12 Removed image(s) 13 Article name 14 Article Title and General Comments 15 Palatal obturator move to own article? 16 Is it getting out of control now? 17 Pharyngeal flap surgery 18 Concerns about the photo of the young boy 19 Cleft ... 20 Discrepancies between statistics and the text of the article 21 Wikiproject Cats/Dogs banners 22 Psychosocial issues / Very one Sided 23 I believe that the "Controversy" section is misleading

[edit] Nose

I don't know details, but doesn't a cleft lip often cause a misshapen nose as well? (a quick google search seems to imply this). Should this information be incorporated? - Matthew0028 08:04, 7 August 2005 (UTC)

Cleft happens in the lip and/or roof of the mouth. However, since the nose is close to the lip, the nose might look deformed too. Two sided complete lip cleft often makes it appear that the tissue between the nostrils is completely seperated. A one sided cleft lip might cause a slightly bent nose because the tissue stress 'pulls' the nose to one side. Once the lip is closed by surgery the nose is in these cases usually also corrected. Felsir 07:31, 15 February 2006 (UTC)

I have a cleft and a Deviated Septum which I'm having an operation on in the coming days, and I was lead to belive that this is a common occurance amoung people with clefts.

[edit] Wives' tale

I heard that the term "hare lip" was derived from an old wives' tale where if a pregant woman encountered a hare, the congenital defect would result in her baby.

[edit] CleftClub SPAM

If you are looking for more information about cleft lip and palate, then visit CleftClub.com.

Material removed - advertising not allowed, thanks

All references to CleftClub.com should be removed. The site has been hacked.

[edit] Cosmeric murder, as in cleft-based abortion

Added info and link about cleft abortion <--> eugenics isssue.

[edit] merger suggestion

I suggest to merge Cleft lip and Cleft palate to a new article called cleft and have lip and palate articles redirect. I'm busy updating these articles and find that almost 95% of the information is valid for both articles. From a medical point of view lip and palate are the same deformity, it only describes the severity of the cleft. Cause, Biology, Treatment, Complications etc are almost identical. Felsir 14:32, July 18, 2005 (UTC)

I will move them for you. -SV|t 15:25, 18 July 2005 (UTC)

[edit] Talk:Cleft palate

[edit] Causes: relations to drugs, alcohol etc instead of genetics

Cleft runs in my family (my wife and two sons have it, my daughter has not) so I did a lot of reading on the subject and I have many contacts within the cleft community. I want to mention that cleft is mainly the result genetics. While it is true that smoking, drugs and alcohol are certainly bad for the development of children during pregnancy, it is not the major cause of cleft. These 'habits' are bad for pregnancies in general. In numbers: if one of the parents have cleft, the odds increase to about 7%. If two relatives have cleft odds increase further to 15% (where 0.3% is for 'regular people') Smoking increases the odds from 0.3% to ~0.8%. While smoking increases other factors (low weight at birth) with much higher numbers.

The genetic factor is confirmed in many international studies under large population of families with cleft (in fact, my family took part in such research in a combined effort of Dutch and German universities).

I feel the article should inform people about the genetic factor and warn people that smoke, drug, alcohol is bad for pregnancy in general. The article now over emphasises drug abuse etc that I find it offensive to people who didn't smoke/drink but have children with cleft.

Material above dump merged from talk:cleft palate. -SV|t 15:34, 18 July 2005 (UTC)

[edit] Joaquin Phoenix

Doesn't Joaquinn Phoenix also have a Cleft? I thought it might be suitable to add to the list of famous people.

Clarified the scar on Joaquins lip. It is not really cleft but has some relation to it. Felsir 07:24, 15 February 2006 (UTC)

[edit] Causes of Cleft Lip/Palate

The statement, "The cause of cleft lip and cleft palate formation is genetic in nature." is only partly true, and should be modified or deleted. In medical research, the cause is really still in debate, but is recognized to be complicated. Some clefts occur apart from any other abnormality, and some occur along with syndromes. There are over 250 developmental syndromes associated with clefts, and some of these are a result from a single gene condition. The other clefts associated with syndromes are believed to be caused by chromosomal anomalies or are idiopathic (in other words, no known specific cause can be found). On the other hand, these clefts associated with syndromes only account for 3% - 8% of all cleft cases. The rest of these "isolated" cleft cases have causes that are not completely known and are undergoing research. Nonetheless, from what is currently known, tobacco smoking during pregnancy is one factor associated with cleft formation in the developing fetus.

Therefore, I suggest the article change the statement I referred to earlier to incorporate the fact that the causes of clefts include, at least, major genes, minor genes, and environmental factors. A statement that not all researchers in this field completely agree on a clear cause may also be appropriate.

In regards to what was said earlier about environmental causes stated in the article being offensive to those who never smoke/drank alcohol but had children with clefts, I think that the potential of some being offended is not as important as having correct information stated in the article. And anyways, almost every step in growth and development is affected by genetic and environmental factors. With a condition as complex as this, the article would be best to include the current scientific belief that all cases of clefts cannot be explained solely by genetics. -Dozenist talk 02:50, 30 November 2005 (UTC)

• Fully recognizing that I know very little about the science of clefts, I think the above comments make a very good case for changing the article in the recommended way. I support the change. Regarding the potential for offense: how is it offensive to say that clefts can be caused by a variety of factors, one or two of which might be disagreeable to a particularly sensitive person? In any case, wouldn't offsetting the supposedly offensive cause by presenting all of the other potential (and also unknown) causes address the potential for abusive and unnecessary offense? - Jersyko talk 03:58, 30 November 2005 (UTC)

• I forgot to mention (but I was reminded this morning at school) that an appropriate term applied to cleft lip and palate is that the condition is "multi-factoral," referring of course to the many factors involved in its cause.-Dozenist talk 01:32, 1 December 2005 (UTC)

I feel that I have to make a comment here (I stated in an earlier post to find it 'offensive'). First let me explain why I made that comment in the first place. At the time I made the comment, the article looked like it stressed the drug/alcohol factors too much. Basically the drug/alcohol factors were stated at the same level as genetic factors. To me (at the time), it looked as if the article told readers to think "he there is a kid with cleft, their parents must be either drunk or drug addicts". (I will not deny that it is possible that personal emotion (3 family members with cleft) influenced this line of thought).

Now, cleft is indeed multi-factoral, and yes, alcohol and drugs are factors. However, this can be said for nearly any deformity formed during pregnancy. Drugs and alcohol are bad for pregnancies in general. The genetic specialists in our craniofacial team has been participating in a large scale research (cooperation between several dutch and german hospitals with cleft treatment teams) told me that the research confirmed that smoking increased the odds from 0.3% to ~0.8%, while having one family member increases the odds from 0.3% to 7%-10%. So yes, smoking is a factor but it is not as significant as the genetics. The reason while it is "muti-factoral" is because one can have a child with cleft while there is no genetic cause apparent. Therefore other factors must be in play. Unfortunately I can't find the research published on the Internet so it is hard to cite this source. I will ask next time I am at the hospital (which is probably soon, my youngest son's lip will be closed within a few weeks). Felsir 07:42, 13 March 2006 (UTC)

I also read an article last week about clefting and twins. It does occur with identical twins (one fertilized egg) that one of them has some form of clefting while the other twin has none - indicating it is not entirely genetic. The article was in a newsletter for parents with twins so it didn't delve deeper into the subject of the cleft. Felsir 09:05, 31 July 2006 (UTC)

Found an online version of the newsletter in dutch language: [1] (pdf ~27mb in size. See pdf-page 8) Felsir 10:46, 31 July 2006 (UTC)

[edit] Submucosal Cleft Palate - or Hidden Cleft Palate

This should be introduced also. Many individuals have this without knowing it until it is found by chance by an Ear Nose Throat doctor examining a patient for a possible tonsillectomy or if hyper nasal speech is realized.

[edit] Cleft lip and palate in the dog

I would like to add some info about clefts in dogs and other animals, which are a common condition. Would it be better to start a separate article for this? I also have some photos of a cleft lip and palate in a Boxer. --Joelmills 02:23, 3 March 2006 (UTC)

It depends how much info you have. If you have a lot of information, then a small section in this article and an indepth independent article on the subject would be appropriate. If it is only a little information, then having it in this article as a separate section would be reasonable. And make sure you upload photos of the dog's cleft lip and palate, even if they are not included in this article!!! - Dozenist talk 02:32, 3 March 2006 (UTC)

It's just a little info, so I'll add it to this article. And I misspoke, the pictures I have are of a boxer with a cleft lip and a small cleft in the premaxilla, but the dog does not have a true cleft palate (as you'll see). --Joelmills 03:15, 3 March 2006 (UTC)

Nonetheless, the dog with a cleft lip would make a striking photo. - Dozenist talk 03:29, 3 March 2006 (UTC)

[edit] Common treatment schedule

I'm working on a common treatment table, see my first attempt here: User:Felsir/clefttable. Besides the required translation (I can do that myself), I cant get the first row to align correctly... if anyone could assist, itis appreciated. Would such a table fit the article (treatment section)? personally think it is informative and shows there is more to it than just surgery. The timetable is based on the common treatment schedule in the etherlands, I have seen virtually the same schedules on UK and US sites (can't provide links at the moment, as I am typing this from a terminal in a hospital with limited I-access) Felsir 16:49, 21 March 2006 (UTC)

[edit] Removed image(s)

Certian images have been removed by me because they have been added to a category that makes them speediable, most likely Category:Images with no copyright tag. Kilo-Lima|^(talk) 16:43, 15 June 2006 (UTC)

[edit] Article name

I've never heard of a cleft lip or cleft palate being referred to as just a "cleft". Additionally, the word "cleft" does not exclusively refer to cleft lips or palates. I realize, based on Stevertigo and Felsir's discussion, above, that this current article name represents a compromise. However, instead of having separate "cleft lip" and "cleft palate" articles, or one "cleft" article, we should perhaps have one "cleft lift or palate" article. Thoughts? JonathanFreed 00:59, 19 July 2006 (UTC)

Choose the more popular one, redirect the other, and use redirects and disambiguations to their full extent.-- _{Piotr Konieczny aka Prokonsul Piotrus  talk}  21:54, 25 July 2006 (UTC)

[edit] Article Title and General Comments

I have recently become aware of the Cleft entry because I teach a graduate course in cleft palate and craniofacial disorders. [A speech-language pathologist, I am a member of the American Cleft Palate-Craniofacial organization, serve as a reviewer for the Cleft Palate-Craniofacial Journal, pbublished in the field, and have worked both clinically and in a research capacity.]

The field of cleft lip and palate and craniofacial disorders is quite expansive, due to the engagement of multiple disciplines. I thus see great potential for all aspects of this entry to expand (e.g., surgery -- including the nose; embryology; genetics; diagnostic procedures; speech therapy; dental management; ear disease; reimbursement; associated anomalies; and others to be added (e.g., feeding a baby with a cleft; learning disabilities/cognitive disabilities associated with some cleft types; facial clefting; diagnostic techniques). These areas can expand by adapting content from respected textbooks, consensus statements, and parent educational publications already developed by experts in the field -- as well as by reference to evidence-based research.

The transmission of this information requires a highly nuanced and balanced approach, and there is great need this content, globally. I am thus beginning to communicate with members of the professional community to direct their energies toward this entry. However, it will take some time to get mobilized, and require initial planning to reconsider the organization and categorization schema. There is another entry (Craniofacial Team) that is also a bit out of balance, and needs some work as well.

In the meantime, I respectfully request that the readers of this discussion consider changing the name of the entry from Cleft. A cleft can refer to a musical term, a dimple in the chin, or part of a medical term. It is never used as a title fpr a reference article.

In Wikipedia this occurs often, for example Ocean commonly refers to the bodies of water found on earth, however it is also a comic book, a train and a gospel band. If the concensus is that cleft is not the correct name for the article, the reason cannot be because 'cleft' is also a musical term (which actually it is not; the musical term is clef). Felsir 23:23, 28 July 2006 (UTC)

Cleft Palate; Cleft Lip and Palate; Cleft Palate - Craniofacial (as per the Cleft Palate- Craniofacial Journal and the American Cleft Palate -Craniofacial Association) I'd yield to a professional committee's consensus if they ultimately enter this discussion and suggest a different term than my preference, but for now, urge a name change to one of the three above, as suggested by the above discussant. Ellen Cohn

My preference would be Cleft Lip and Palate. As stated in a discussion message above it could easily be linked so 'cleft' would redirect to the new name (see flu it redirects to the correct term influenza). One has to look at it from two ways:

A) this is an encyclopedia so information should be correct and factual (so the article's name should be correct)

and

B) this is an encyclopedia so people must be able to look things up (and therefore the layman term should be included to enable people to find information: if there only was an article named Norma Jeane Mortenson then few people would find Marilyn Monroe).

So what is the correct name? There obviously is not a single correct one. Cleft palate and Cleft lip both redirect to this article so those two are covered. If this article is renamed cleft lip and palate it is both correct and understandable. Felsir 23:23, 28 July 2006 (UTC)

If we move the article, then we have to deal with the technical question whether cleft should redirect to Cleft (disambiguation) or to 'cleft palate or something' article, with that article displaying a disambig note Cleft redirects here. For other meanings see Cleft (disambiguation) (note this can be done with Template:Redirect). I would recommend redirecting cleft into a disambig, as we should use a more specific term throughout articles (that means we should go over 'what links here' and make bypass the disambig, of course). As for the particular name, not being a specialist here, as a layman (i.e. as most people who will read this entry) I would thinkt that cleft lip and palate is the most logical name, combining both cleft lip and cleft palate redirects, and hopefully satysfing supporters of both names. Last but not least it is encouraging to see professionals taking interest in Wikipedia, I think we are all looking forward to their contributions.-- _{Piotr Konieczny aka Prokonsul Piotrus | talk}  00:28, 29 July 2006 (UTC)

I personally think that the solution will be to rename this article to cleft lip and palate, and having cleft either be a disambig or a redirect to this article. The subjects of cleft lip and cleft palate would have to be introduced/summarized in this article, and then the majority of the article would be about when both appear together. Once the information in this article becomes more complete, I would imagine the sections dealing solely with cleft lip and the section dealing with cleft palate will be extensive enough to branch out into their respective articles. - Dozenist talk 03:45, 29 July 2006 (UTC)

Now I think of it, in dutch there is one name schisis (derived from Greek for 'gap') that acts as a collective word for cleft lip and palate. So one speaks of a child with schisis and the type would be lipspleet (cleft lip) and/or gehemeltespleet (cleft palate). I was wondering if such word also existed in english? Felsir 08:39, 31 July 2006 (UTC)

Clever concept, Felsir! I hope that when we finally get the Cleft entry in shape, it can be translated into other languages.

I also like Dozenist's approach to the naming issue. (Your wikipedia work is superb in dentristy! As you probably already know, children with cleft lip =/- palate have multiple dental issues, and often require several dental specialists. Hope you will watch over those sections as they develop, and perhaps write a bit...) --Ecohn 03:08, 2 August 2006 (UTC)

[edit] Palatal obturator move to own article?

A palatal obturator is an often used prosthesis in cleft palate treatment. The article however states "Palatal obturator is needed by individuals with cleft palate, those who have had tumors removed or have had traumatic injuries to their palate." thus the prosthesis is not exclusive to cleft treatment. This makes it a valid entry for a new article IMHO. The cleft article could include a brief section about the obturator and point to this new detailed article. Opinions? Felsir 17:50, 29 July 2006 (UTC)

Sure, let's create an entry on palatal obturator if we have enough content. At the very list, a redirect is needed.-- _{Piotr Konieczny aka Prokonsul Piotrus | talk}  20:42, 29 July 2006 (UTC)

I moved the section to a new article palatal obturator. I think someone needs to review the new article for readability. I mean the sections are well written, but it contains a lot of medical jargon so it's not entirely clear to the average reader what it actually is (which defeats the purpose of an encyclopedia IMHO). Felsir 08:58, 31 July 2006 (UTC)

For starters we can stick {{technical}} on the talk, and hopefully this will attract more attention from somebody who can help with that.-- _{Piotr Konieczny aka Prokonsul Piotrus | talk}  13:55, 31 July 2006 (UTC)

[edit] Is it getting out of control now?

Let me start by saying this: I welcome all new editors to add valuable content to Wikipedia's articles. However, things are getting out of hand in this article. The Craniofacial team section is transformed from a simple basic explaination to a huge chunk of text (copied and pasted as it starts with "Cleft lip+/- palate is a congenital disorder of the craniofacial complex that occurs early during pregnancy and is present at birth" which is basically what the entire article is about). There is an entry craniofacial team that deals about the specifics of the team. The chunk of text would perhaps be more relevant in that article. The text needs to be reviewed for technical details (similar to the palatal obturator text). The same thing applies to the sections about Pharyngeal flap surgery. The surgery should be mentioned in the treatment section with a brief description what it actually is, if it warrants three subsections (including the procedure's history) it's also better to move it to an article of its' own (now it appears to be very a important aspect of cleft treatment while it's not required in many of the cases). The cleft article seems to move from informative to a medical textbook. I'm leaning towards removing those sections as they are obviously copied from medical papers (I believe it's also agains the Wikipedia guidelines - however I can't find the specifics at the moment). I really welcome any professional to add information, but please do so in the spirit of the article, not just to plainly dump information in an articly adding sections without looking at the bigger picture. Am I overreacting? Felsir 12:51, 2 August 2006 (UTC)

Please note that the recent expantion of this article is a result of this SUP activity. As such, I am sure the additions are not 'copies from medical papers', but proper papers themselves, referenced and with no OR. Unfortunately the studends have relatively little previous experience with Wikipedia, so even after few hours or instruction on 'how to' and stress on doing the Wikipedia:Tutorial, we still end up with lots of unwikified text and issues like reference sections in the middle of articles. I agree that there has been too much material added here, and some of it is too technical - certainly way above the level of general audience (especially in unwikified parts, with few interlinks to technical jargon). Still, I believe we can deal with this: we know how to copyedit the article, and added material is valuable.-- _{Piotr Konieczny aka Prokonsul Piotrus | talk}  13:45, 2 August 2006 (UTC)

I'm sorry I was not aware of this, thank you for clearing things up. So perhaps I was overreacting ;-) I do agree the information is valuable - it's why I didn't remove it but added my remarks to the talk page instead. As I said, I do welcome any valuable addition. I will review the sections later and move some parts to new articles where apropiate. Felsir 17:33, 3 August 2006 (UTC)

[edit] Pharyngeal flap surgery

I made four sketches based on what I know of the surgery. Perhaps these need to be checked (my drawings look similar to ones I found using Google, but still). Now I think of it, the surgery is not part of the cleft repair in itself - it is closely related, but as far as I know it is only used to correct the speech. The majority of the cases where the surgery is applied is probably cleft palate, but it is not exclusive to cleft palate. Also people with a cleft palate do not alway require this surgery. Therefore I feel that this section would best have it's own article. Felsir 09:39, 4 August 2006 (UTC)

I moved the section to it's own article: Pharyngeal flap surgery. I am not sure what entries in the references section in the cleft article should move also.Felsir 09:16, 8 August 2006 (UTC)

[edit] Concerns about the photo of the young boy

The photo is unrepresentative. It depicts an unrepaired unilateral cleft lip in a young boy; most cleft lips, at least in the US, are repaired at 10 weeks of age. The individual with the cleft also appears to be African American --the racial group with the lowest incidence. There could also be serious confidentiality/consent issues if the family did not sanction inclusion of the photo. I believe the photo should either be removed, or captioned properly. ecohn (—The preceding unsigned comment was added by 24.131.83.20 (talk • contribs).)

The picture notes that it was taken with the consent of the parents, and although the country is not specified, the photographer is from India, meaning that the photo was likely taken there. I am sure he would be happy to answer further questions.-- _{Piotr Konieczny aka Prokonsul Piotrus | talk}  08:36, 26 August 2006 (UTC)

Thanks for the clarification. Can the term unrepaired (i.e., unrepaired unilateral cleft lip) be added to the caption? Also, it would be good if we could locate an unrepaired cleft in a baby, with a second photo of the repaired result.24.131.83.206 12:59, 31 August 2006 (UTC)ecohn24.131.83.206 12:59, 31 August 2006 (UTC)

[edit] Cleft ...

I am a proud mother of a three year old boy, who is born with a cleft lip and palate on the right side. This we knew before he was born. His doctor told us that 40% of children with cleft do not have any relatives eith cleft but there are known families where cleft seems to be genital.

Also we have discussed thar possibilities that it might the genes of boys or girls depending on families.

We live in Iceland and here there are 4-8 children every year born with some kind of a cleft. Fortunanetly we have a superb doctor (and other medical stuff).

I also have somw photos if any one is interested to see the changes on my boy after the surgerys :)

(pardon my english .. getting a little "rusty") —The preceding unsigned comment was added by 85.197.223.8 (talk • contribs).

Dear anon. We welcome all contributions, and if you can share those informative photoes with us to enhance this article, by all means, please do so. Take care and consider registering. You may also be interested in contributing to the Icelandic Wikipedia. -- _{Piotr Konieczny aka Prokonsul Piotrus | talk}  04:48, 24 September 2006 (UTC)

[edit] Discrepancies between statistics and the text of the article

The article first gives statistics indicating that Latin Americans display a cleft lip at the second lowest rate among various racial/ethnic groups, and then one of the following sections goes on to state that "[clefting] occur[s] most often among Asians, Latinos and Native Americans." If one takes "Latino" to be the same as "Latin American," which I think is a reasonable interpretation in this case, this discrepancy makes the accuracy of the article very dubious. The same must be said about the statistics which show the Japanese to have either the second lowest rate of clefting (after only African Americans) or else the third highest rate of clefting (after Chinese and North American Indians). Which one is it? Do the Japanese present an especially low rate of clefting or a slightly higher than average rate of clefting? Someone with specialized knowledge in this field needs to review those sections carefully and eliminate any contradictions. Ebizur 09:42, 17 November 2006 (UTC)

[edit] Wikiproject Cats/Dogs banners

The "clefting in animal" section is a small part within this article. If the cleft in animals section is expanded it would most probably move to it's own article. While I welcome any additions to the article, I think it's a little weird to have the cats and dogs portal banners up (as it is such a tiny aspect of the article). The bone fracture article doesn't have this tags and yet cats and dogs can have a fractured bone, so should all possible scenarios include the cats/dog banners? On the other hand, clefting also occurs with other mamals, wouldn't it be too much to have banners for all animals where clefting occurs? IMHO this is a case of getting a bit carried away in trying to include too much. Felsir 10:57, 20 November 2006 (UTC)

Removed the banners, no response from the Cats/Dogs project group. Felsir 13:42, 27 November 2006 (UTC)

[edit] Psychosocial issues / Very one Sided

Being born with a Full Bi-Lateral Cleft I found the Psychosocial Issues section to be a bit vauge. (I will work on an article for this) No where was there discussion on the positive aspects of having a cleft. Almost discriminating to a point. Many individuals with Clefts whether full or partial have a very positive and productive social standing throughout their youth, teen, and adult years. It all depends what you see in the mirror. One part discussed which I did appreciate is parental involvment, which is crucial to social development.

Kane 12:40, 28 November 2006 (UTC)

[edit] I believe that the "Controversy" section is misleading

The "Controversy" section would lead one to believe that in the UK, cleft palate is a legally sound reason for a late abortion. As cleft palate is repairable and not a "serious handicap", this is clearly not the case. The included BBC link also states this:

Her lawyers argued in the High Court that there should have been further investigations with a view to prosecution, because an abortion could never be justified under the 1967 Abortion Act on the basis that a cleft lip and palate were a serious handicap.

138.243.228.52 15:31, 9 December 2006 (UTC)