Dawaa Reference

chronic

Cleft lip and palate

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Cleft Palate - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK563128/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD55.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Cleft lip and palate - disease-level clinical article (cleft-lip-palate-full.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

  • Concomitant cleft palate causes poor feeding and difficulty swallowing, and affects speech [difficulty swallowing · poor feeding]
  • Red flag: it usually takes several operations and a whole team, costs a great deal, and leaves many of these children with lifelong psychological problems

Signs — what you find (6)

  • Cleft lip can be unilateral or bilateral, and complete or incomplete
  • In bilateral cleft lip, the premaxilla may be pushed forward and need presurgical molding before surgery
  • Alveolar clefts should be documented carefully as part of the exam
  • The mildest grade, microform or occult, leaves the lip incompletely separated and the vermillion border distorted but not broken
  • The incomplete grade breaks through the vermillion border, often pulling the nostril rim down, but the floor of the nose stays intact behind a fibrous Simonart band
  • The complete grade separates the lip and the floor of the nose together

Tests (1)

  • Antenatal ultrasound can identify a cleft deformity by the second trimester

If not this — what else fits (2)

  • Acute primary hepatitis stomatitis appears on the differential list
  • Aphthous ulcers, pemphigus, pemphigoid, and erosive lichen planus are also on the differential list

SourceStatPearls "Cleft Lip" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Congenital facial anomaly affecting feeding, speech, and hearing; needs a multidisciplinary cleft team (plastic surgery, ENT, speech therapy). GP's role is early referral and practical feeding advice (special bottles/nipples, upright feeding) while awaiting surgery. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Congenital facial anomaly affecting feeding, speech, and hearing; needs a multidisciplinary cleft team (plastic surgery, ENT, speech therapy). GP's role is early referral and practical feeding advice (special bottles/nipples, upright feeding) while awaiting surgery.

Cautions
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Parents must be taught red flags requiring urgent evaluation, including potential for aspiration, choking, airway obstruction, and failure to gain weight.
  • RED FLAG - Feeding difficulty or poor weight gain, or other anomalies suggesting an associated syndrome: refer for paediatric assessment.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.