Ultrasound of Cleft Lip and Palate

Type

Chromosomal
Anomalies
/ Mortality

Type 1
- Unilateral.
- Best seen on coronal images of the upper lip.
- Midline sagittal views normal.
- Involve the superficial tissues.

O% / 20%

Type 2
- Unilateral.
- Best seen on coronal images of the upper lip.
- Clefts extend deeper into the face with distortion or disruption of bony structures.

20% / 33%

Type 3
- Premaxillary protrusion (paranasal echogenic mass).
- The protrusion is usually more prominent than the adjacent clefts.
- Seen on coronal, transverse and sagittal images.

30% / 50%

Type 4
- Large midline cleft lip and palate.
- Hypoplastic midface (flattened nose and maxilla on coronal, transverse, and/or

sagittal views of the face.

52% / 100%

Type 5
- Amniotic band syndrome or limb-body wall complex.

0% / 100%

 

 

 

 

Type 1 Cleft lip

Cleft lip and palate

Cleft lip and palate

 

 

 

 

 

 

 

3D - Unilateral cleft lip

 

Type 2 – Cleft lip and palate

 

 

 

 

 

 

 

 

 

 

3D images

Type 3 – Cleft lip and palate

 

 

 

 

 

 

 

 

 

 

 

Bilateral cleft lip with pre-maxillary protrusion

 

 

 

 

 

Type 4

Midface hypoplasia

Type 5

 

 

 

 

 

False positive cleft lip

Normal indentation on upper lip - philtrum

False positive cleft of upper lip

  • Sagittal view of the facial profile is slightly rotated giving the impression of a prominent upper lip and premaxillary protrusion.
  • The normal upper lip and maxillae can be demonstrated on a true sagittal view.

 

False positive cleft lip

        Artifactual line across the upper lip disappears on changing transducer orientation.

Cleft Lip and Palate

Fetus with mouth open demonstrates a defect which is part of the open mouth. The lower two images demonstrates normal upper and lower lips.

Cleft of upper lip

 

 

 

REFERENCES

  1. Nyberg DA, Sickler GK, Hegge FN et.al. Fetal cleft lip with and without cleft palate: US classification and correlation with outcome. Radiology 1995;195:677-684.