Anatomy and Physiology

Cleft lip and palate is the most common congenital craniofacial disease. Multiple studies have shown that the medial nasal process remains centralized and fails to fuse with the lateral maxillary process during their development, resulting in the characteristic deformity after birth. This abnormal anatomy with communication between the oral and nasal cavities is associated with important functional disturbances affecting feeding and breathing process initially and the subsequent development of speech. The nasal deformity characteristics include short and deviated columella, nasal septum deviation, lack of tip projection, and nasal sill absence on one or both sides. Interdisciplinary management of the functional problems related to this abnormal anatomy in patients with cleft and palate is necessary and involves otolaryngologic management for hearing and middle ear disease, speech language, nutritionist assessment of feeding, and dental and psychosocial counseling for the family. This chapter presents a description of the cleft lip nose anatomy and function and basic and fundamental knowledge for understanding this pathology and its treatment.