What is cleft?

Schisi is synonymous with SPACE ; with cleft it is usual to indicate a type of tissue cracking genetically determined or otherwise influenced by familiarity; during embryonic development, those affected by cleft do not reach the continuity of one or more areas or segments that appear therefore interrupted and / or incomplete due to the lack of fusion of the two tissue heads.

Types of clefts

Simply put, cleft is a type of malformation that differs according to the region concerned; the most common forms of cleft are:

  • Cleft lip or cleft lip : more commonly called cleft lip; it is a crack between the upper portion of the mouth and the lower portion of the nose. The cheiloschisis can be mild, affecting only the soft tissues of the lip, or more serious and also affecting the bone / cartilaginous floor of the nasal cavities and / or the teeth; severe cheiloschisis causes complications of swallowing with passage of the bolus or residues of it to the respiratory tract, increasing the risk of bronchopneumonia (especially in infants and young children). The treatment of cleft lip is surgical and ranges from a simple facial plastic to a real maxillofacial operation after one or two months from birth.
  • Cleft palate: it is a malformation of the palate; it appears as a spacing of the anterior portion of the hard palate and is often associated with cleft lip. In the most serious forms, the whole soft palate, the palatal vault, the alveolar portion of the palate and the uvula itself are compromised; the cleft palate, in addition to favoring bronchopulmonary infections by aspiration of the alimentary bolus, can favor a serious alteration of the language capacity. Plastic surgery is essentially applied within the first month of life.
  • Rachischisi : also called spina bifida; is a malformation of the spine and spinal cord in which the canal remains incomplete and favors the escape of medullary hernias. Cracking can also affect nerve tissue (neuroschisis), bone tissue and the overlying cutaneous region with exposure of the medullary canal (spina bifida cyistica); if the skin is intact and looks like a hair-covered dimple, spina bifida is called occult.

    NB . When the malformation affects ALL the rachis is called rachischisi.

    The symptomatology depends on the severity of the general condition and manifests itself proportionally to the nerve damage; if spina bifida is occult, the symptomatology is absent. In severe cases, surgery is essential but only palliative.

  • Neuroschisis : as anticipated, it is a cracking of the nervous tissue; may be associated with spina bifida affecting the spinal cord or extending beyond it to the cerebellum. The neuroschisis is extremely disabling and in the most serious cases it involves paresis of the limbs and fecal and / or urinary incontinence. The surgery for neuroschisis is applied above all in the cases of spina bifida cistica towards which it plays a palliative role (exposure of the medullary canal) in order to reduce the risk of infection.