Median cleft lip/mandible

Median cleft lip with mandible cleft (also known as median cleft of the lower lip and mandible, or midline cleft of the lower lip and jaw) is an extremely rare congenital craniofacial malformation characterized by a vertical cleft occurring in the midline of the lower lip, which may extend through the chin and mandible (lower jaw). This condition results from a failure of fusion of the paired mandibular prominences during early embryonic development. The cleft can vary in severity from a minor notch in the lower lip vermilion to a complete cleft extending through the lower lip, chin soft tissues, mandibular bone, and occasionally involving the tongue and floor of the mouth. In some cases, it may be associated with other midline defects including ankyloglossia (tongue-tie), cleft of the tongue, or defects of the anterior neck structures. The condition primarily affects the craniofacial system, specifically the lower face and jaw structures. Associated features may include bifid tongue, submental skin deficiency, and in severe cases, involvement of midline cervical structures. The condition is typically apparent at birth. Treatment is surgical and involves reconstruction of the affected structures, including repair of the lip, soft tissues, and mandibular bone as needed. Surgical management is generally planned based on the severity of the cleft and may require a multidisciplinary approach involving craniofacial surgeons, oral and maxillofacial surgeons, and speech therapists. Outcomes following surgical repair are generally favorable, particularly in isolated cases without associated systemic anomalies. The condition is distinct from the more common lateral cleft lip and should be differentiated from other midline facial clefting syndromes.

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