Question:medium

Based on the clinical photographs shown, identify the facial anomaly depicted (bilateral defect of the upper lip with associated nasal deformity).

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Two paired defects flanking the midline with a central premaxilla.
Updated On: Jun 25, 2026
  • Bilateral cleft lip
  • Midline cleft lip
  • Cleft palate
  • Oblique facial cleft
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The Correct Option is A

Solution and Explanation

This is a pattern-recognition question anchored on the location and symmetry of the lip defect.

Embryologically the upper lip is built where the paired maxillary prominences meet the fused medial nasal prominences. The line of fusion lies just lateral to the midline on each side (the philtral columns). A cleft therefore appears off-midline, and when fusion fails on both right and left it is a $bilateral$ $cleft$ $lip$, classically leaving the central premaxilla projecting forward with a foreshortened columella.

Differentiating the options by site and embryology:
$\bullet$ Midline cleft lip to central defect from failed merging of the two medial nasal prominences; linked to holoprosencephaly - rare.
$\bullet$ Cleft palate to gap in the palatal shelves (roof of mouth), not on the visible lip.
$\bullet$ Oblique (Tessier) facial cleft to defect tracking obliquely from lip to orbit - very rare.

Paired, symmetric upper-lip clefts with an isolated premaxilla match only one diagnosis:
\[\boxed{\text{Bilateral cleft lip}}\]
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