Please click to enlarge.
Note what signs you see.
I (S. Kalynka, M.D.) see:
- Lip, lateral maxillary process, not fused (cleft) with prolabium.
- Nose, nostril, incomplete.
- Prolabium, attached to nasal tip.
- Tongue, developed.
- Palate, soft, not developed, agenesis.
- Palate, hard, not developed, agenesis.
- Oro-nasal-pharyngeal cavity, single.
NOTE: please view a companion image illustrating the above from a slightly different angle.
PERSPECTIVE: this instance illustrates how categorizing this patient as an instance of cleft lip and palate (CL/P) is insufficient – CL/P is fundamentally a failure of “fusion” and epidemiologic studies convincingly demonstrate that it results from concurrent impacts by multiplicity of genes which do not impact cerebral development. On the other hand, the “median” “agenesis-dysgenesis” of nasal and prolabium development are quite characteristically associated with anomalies of derivates of the prosencephalon.