One Cleft, Many Shapes, The Cleft Spectrum
What makes one different from another, and where does Mateo's cleft fall in the full spectrum?
💡 Any can be placed on three axes: or , complete or incomplete, overt or submucous.
Prerequisite check
- An international survey of 197 providers found 18 systems in use, with ICD-10 (35.5%), LAHSHAL (34.0%), Veau (32.5%), and the striped-Y (22.8%) most common.
- Veau sorts clefts into four groups by which structures are clefted, divided at the , and acts as a rough severity proxy.
What you will learn
Goal: Distinguish clefts along three axes ( vs , complete vs incomplete, overt vs submucous) and place Mateo within that spectrum.
- A involves one side; a cleft involves both, leaving a central segment standing forward and a short .
- A runs through the full structure; an incomplete lip spares a bridge of skin called a .
- A hides under intact mucosa, with a triad of bifid uvula, translucent zone, and a hard- notch.
- Because the levator sling still fails, a submucous can cause the same speech problems as an open one; surgery succeeded in 82.1% of one submucous series.
Model: Four newborns and the three axes
The team reviews four composite cases (teaching cases, not real patients). Baby A (Mateo): the lip is split into the left nostril, continuing through the gum ridge and whole roof of the mouth on the left; the right side is intact. Baby B: both the right and left lip are split into their nostrils, with a central block of lip and gum standing forward; the is clefted on both sides. Baby C: the left lip has a small notch near the top, but a band of skin still bridges the gap so the does not reach the nostril floor; the palate is closed. Baby D: the roof of the mouth looks closed and pink, but the uvula is split in two, a bluish translucent stripe runs down the of the soft palate, and a notch can be felt at the back edge of the .
The same organizes into three yes-or-no questions a surgeon asks about any . One side or both: versus . All the way or partway: complete versus incomplete (the surviving skin bridge in an incomplete lip is a ). Open or hidden: most clefts are overt, but a is hidden under intact mucosa with the classic triad above. Because the muscle is still clefted underneath, a submucous cleft is a real defect that can need treatment.
Explore (work the model before reading on)
- Which baby has a on both sides?
- Which baby's does NOT reach the nostril floor because a band of bridges it?
- Which baby has a that looks closed but is clefted underneath?
- Baby D's looked closed. Why can it still cause the same problems as Baby A's wide-open ?
- Predict: which is easier to miss on a quick , Mateo's or Baby D's submucous cleft, and what danger comes from missing one?
Guided notes
Side and extent
- Side: ____ (one side) versus (both sides, with a central segment standing forward).
- Extent: a runs the full structure; an incomplete lip spares a bridge of skin called a ____ band.
Visibility
- A ____ hides under intact mucosa; its triad is a bifid uvula, a translucent zone, and a hard-palate notch.
- It still disrupts the muscle, so it can cause the same ____ problems as an open .
Placing Mateo
- Mateo is (left only), ____ (reaches the nostril and runs the whole ), and overt (open).
Reading the Research
- Skim the title and abstract first to get the gist.
- Circle the one sentence that states the main claim.
- Box the evidence the authors give for that claim.
- Mark one sentence that confuses you, and move on.
Vocabulary (the same words your classes use)
Track your progress today
Check these off as you work through the lesson, then submit. This tells Mr. Mendoza how you're doing so he can help the class. It does not replace turning in your producible.
Use the code Mr. Mendoza gave you, not your name. Saved on this device.
- Read the Model and answered the Explore questions.
- Filled in the guided notes in my own words.
- Defined the new vocabulary with an example.
- Built the producible: Triage the four newborns. Build a table with columns "unilateral/bilateral," "complete/incomplete," and "overt/submucous," and fill a row for each baby (A, B, C, D). Then write one sentence on which baby is easiest to overlook and what you would tell a newborn nursery to check. Circle Mateo's row and state his three-axis description in one phrase.
- Wrote my Claim, Evidence, and Reasoning exit ticket.
Exit ticket (Claim, Evidence, Reasoning)
- Claim: Mateo's place in the spectrum is , complete, and ____ (overt/open).
- Evidence: Name one other form from today and one feature that distinguishes it from Mateo's.
- Reasoning: Explain why a submucous , even though the looks closed, still counts as a real cleft that needs care.
| Criterion | Proficient | Developing | Beginning |
|---|---|---|---|
| Complete | Every required part of the artifact is present and filled in. | Most parts are present, but one is missing or left blank. | Several parts are missing. |
| Accurate | The science and data are correct and match the evidence. | Mostly correct, with a small factual slip. | Key science or data is wrong. |
| Scientific reasoning (CER) | States a claim, backs it with specific evidence, and explains the reasoning. | Has a claim and evidence, but the reasoning is thin or missing. | Gives an answer with no evidence or reasoning. |
| Professional communication | Clear, organized, and labeled the way a clinician or scientist would write it. | Readable but disorganized or missing labels. | Hard to follow. |
| Submitted | Turned in the right way (Schoology for routine work) and confirmed. | Turned in, but in the wrong place or unconfirmed. | Not turned in. |
- CompleteProficient: Nothing is left blank: the model fills every part of "Triage the four newborns. Build a table with columns "unilateral/bilateral," "complete/incomplete," and "overt/submucous," and fill a row for each baby (A, B, C, D). Then write one sentence on which baby is easiest to overlook and what you would tell a newborn nursery to check. Circle Mateo's row and state his three-axis description in one phrase.".
- AccurateProficient: Every number and claim matches the case evidence.
- Scientific reasoning (CER)Proficient: It names a claim, cites the specific evidence, and explains the reasoning, not just the answer.
- Professional communicationProficient: It is organized and labeled like a real chart note.
- SubmittedProficient: It would be turned in on Schoology and confirmed.
Where this leads: careers
What's next: We have pinned Mateo to the spectrum: , complete, overt. But describing his does not solve his most urgent problem. His open cleft connects his mouth and nose, and his parents are most afraid he cannot eat. Why can't Mateo feed normally, and what helps now? We chase that next time.