craniofacial

• AKA preaxial acrofacial dysostosis
• micrognathia
• zygomatic hypoplasia
• downward slantting palpebral fissures from hypoplastic orbitomalar
• dolichofacial
• cleft palate
• preaxial limb deformities. 

• Zygomatic hypoplasia +
• Downslanting palpeblar fissures +
• Lower eyelid colobomas
• Mandibular hypoplasia +
• External ear malformation +
• Limbs
• Thumb aplasia or hypoplasia
• Radial defects +
• Others
• Genitourinary abnormalities +
• Reduced stature +

• branchial arch 1,2
• limb buds

failure of fusion of the lateral palatine processes, the nasal septum, and/or the median palatine processes (formation of the secondary palate).

failure of fusion of the maxillary and medial nasal processes (formation of the primary palate).

• rule of 10s
• 10 weeks of age; weighs at least 10 pounds, and has at least 10g hemoglobin

The rotation-advancement procedure for cleft lip repair, also known as the Millard Repair, is designed to create a softer, more natural-looking lip. Surgery performed prior to the Millard procedure involved pulling both sides of the cleft lip together resulting in a tightly closed upper lip. The Millard Procedure rotates the tissue and creates a "Z" shaped scar instead. The "Z" shape gives the tissue more elasticity, resulting in greater flexibility and restoration of the Cupid's bow.[2]

• between 6 and 12 months.
• Approximately 20–25% only require one palatal surgery to achieve a competent velopharyngeal valve capable of producing normal, non-hypernasal speech.

surgically inserted by use of pins during the child's 4th or 5th month. After it is in place, the doctor, or parents, turn a screw daily to bring the cleft together to assist with future lip and/or palate repair.

surgery for speech correction done at 3-4 yrs old

• done 5-9 yrs old if necessary
• may need palatal expansion