duplicated gluteal cleft newborn. 2 may differ. duplicated gluteal cleft newborn

 
2 may differduplicated gluteal cleft newborn  The code is exempt from present on admission (POA) reporting for inpatient

27 This study also evaluated 207 neonates with cutaneous stigmas and found that none of the infants with a simple midline dimple (meeting none of the criteria listed above) had spinal dysraphism. 5 cm above the anus) and solitary. little man has a duplicated gluteal cleft. P92. A pilonidal cyst, also referred to as a pilonidal abscess, pilonidal sinus or sacrococcygeal fistula, is a cyst or abscess near or on the natal cleft of the buttocks that often contains hair and skin debris. A cross-sectional assessment of cutaneous lumbosacral and coccygeal physical examination findings in a. CONCLUSION. The gluteal cleft and the gluteal fold both occur normally in humans. ), and relevant articles were selected by mutual agreement. By Perrine Juillion / October 25, 2019. 2 may differ. Some consider the term spina bifida occulta. Gluteal cleft Meaning - YouTube. 7% had lumbosacral and/or coccygeal hairiness. Y shaped gluteal waiting for scan. Concerning findings warranting further work -up: dimples located superior to natal cleft or more than 2. 5 may differ. The rest of the physical. With thousands of award-winning articles and community groups, you can track your pregnancy. This can then lead to the subsequent formation of a subcutaneous abscess from a persistent folliculitis. He presented with a verrucous wart-like midline mass on the superior gluteal cleft that had grown since his last resection. A coccygeal pit was. g. my full-term newborn boy has an asymmetric 'y' shaped crease at the top of his intergluteal cleft. A pilonidal cyst can be extremely painful especially when sitting. Pediatrician said she wasn’t worried at all since she has good leg movement and stuff, but she’ll keep an eye on it. 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 8 is a billable diagnosis code used to specify other congenital malformations of musculoskeletal system. DX? dmaec True Blue. They believe everything is okay after her Neurodevelopmental eval but we monitor her for any changes in behavior as she gets older. Spinal dysraphism encompasses congenital problems that result in an abnormal bony formation of the spine and/or the spinal cord. Germolene. Linear lesions in the intergluteal cleft are caused by moisture with or without a friction component and should be classified as intertriginous (between skin folds) dermatitis (inflammation of the skin). Any dimple lying superior to the gluteal cleft, outside the midline, and with a diameter greater than 5 mm commonly accompanies a spinal anomaly and warrants radiological investigation such as an MRI. Case reports of median tongue clefts in the literature show mostly a combination with a cleft of the median lower. 5 cm above the anus) and. 155 Other ear, nose, mouth and throat diagnoses with cc. - "A Cross-Sectional Assessment of Cutaneous Lumbosacral. 6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. basically, the top of his bum crack makes a y shape…Red Flags! •Midline (or near-midline) tuft of hair (hypertrichosis) •Midline (or near-midline) capillary hemangioma •Midline (or near-midline) subcutaneous mass (lipoma) •Caudal appendage •Deviated or duplicated gluteal cleft •Expression of fluid from dimple •Dimple located more caudally •Inability to see base •Swelling/erythema around. little man has a duplicated gluteal cleft. Dimensions of the proposed intramuscular pocket are designed and the bilateral gluteal cleft incisions are marked. [email protected] uvula. Cleft lift procedure overview. 2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The patient was born at 40 weeks and 1 day of gestation to a 21-year-old gravida 2 now para 2 mother by vaginal delivery. A bifid uvula, also known as a cleft uvula, is a uvula that is split in two. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. He had an ultrasound at a week old and it was negative. 5 cm above the anus or proximate to the coccyx, and deviated gluteal folds (DGF) including all types of folds (bifid and split symmetrical without underlying. Approximate Synonyms. Cleft foot is a rare congenital (meaning your baby was born with it) anomaly in which the foot didn’t develop properly during fetal development. A decision-analytic model was constructed to project the cost and health outcomes of magnetic resonance imaging (MRI), ultrasound (US), plain radiographs, and no imaging in newborns with suspected occult spinal dysraphism. A neonate Caucasian girl, a product of an uncomplicated pregnancy, was found to have asymmetric gluteal crease. The hip joint is the most stable joint in the body and is supported by a very strong capsule and several. Here are some of the things I have tried myself at different times as decided by myself and my girlfriend: Sudocrem every night. A sacral dimple can be a sign of a serious spinal problem in a newborn if the dimple is large or appears near a tuft. The gluteal cleft shield is directly applied on the skin and fixes itself above the waistband. This is mostly a problem with HSG preoperative evaluation. Study sets, textbooks, questions. Q82. This is the American ICD-10-CM version of Q37. (B) Sever all knee ligaments. Z87. findings (hypertrichosis, haemangioma, caudal appendage, deviated gluteal fold, discharging sinus, etc) > 5mm in diameter, situated above the natal cleft or > 25mm from anus. from anal verge, multiple dimples, Skin lesions and Associations (duplicate gluteal cleft, asymmetrical intergluteal crease, skin tag, tail like appendages, hairy tuft, pigmentation, Anomalies of the gluteal crease had the lowest proportion of agreement. Morbidity and. Newborns who became symptomatic were further evaluated and/or treated with antibiotics. 110 749. 7 - other international versions of ICD-10 Q35. 1 became effective on October 1, 2023. Sacral dimple newborn – a prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. The 2024 edition of ICD-10-CM Q35. 02 [convert to ICD-9-CM] Gluteal tendinitis, left hip. 9 may differ. Had our first well check today and a scheduled ultrasound. The intergluteal cleft or just gluteal cleft, also known by a number of synonyms, including natal cleft, butt crack, and cluneal cleft, is the groove between the buttocks that runs from just below the sacrum to the perineum, [1] so named because it forms the visible border between the external rounded protrusions of the gluteus maximus muscles. 27 This study also evaluated 207 neonates with cutaneous stigmas and found that none of the infants with a simple midline dimple (meeting none of the criteria listed above) had spinal dysraphism. In many situations they heal on their own. 6 E. SPINE: Normal curvature with no defects or dimples. As the tittle says I am currently waiting on a back scan for my little man hes 14 weeks old hes got a y shaped gluteal cleft, it feels dead boney where this is. The internet is a wonderful resourceWe would like to show you a description here but the site won’t allow us. Gluteal cleft. The right gluteal crease is lower than the left. Code Tree. 7% had lumbosacral and/or coccygeal hairiness. When an infant is born with skin lesions or abnormalities of the lower back or gluteal cleft, the possibility of an association with spinal malformations, such as tethered cord syndrome, often prompts pediatricians to recommend spinal imaging. Atypical dimples may be located higher up on the back or off to the side. There is no skin. I’ve noticed my baby has a Y shaped cleft on her bottom. 6 Therefore, we could consider these patients low risk for having OSD. 7% had lumbosacral and/or coccygeal hairiness. View article titled, Lumbosacral Nevus Simplex in a Newborn Girl with an Asymmetrical Y-Shaped Gluteal Cleft. Combinations of deviated or duplicated gluteal crease + dimple, deviated or duplicated crease + hair, and dimple + hair were common groupings. The examination is performed with high-frequency. A duplicated gluteal cleft associated with occult spinal dysraphism. Asymmetry. Most sacral dimples are harmless and don't need treatment. 5 became effective on October 1, 2023. One infant had urodynamics studies and a tethered cord release. 1 became effective on October 1, 2023. Sacral epidermal anomalies include dimples, tracts, lipomas, hemangiomas, and tufts of hair and may be associated with a neural tube defect, such as spina bifida. NEUROLOGIC: Normal tone. 49. A duplicated gluteal cleft associated with occult spinal dysraphism. 2, 3 It is most commonly encountered in young men in their 20s and 30s, although women can also be affected. 4. It has over 40,000 names organized gluteal cleft newborn. The most common cutaneous manifestations were duplicated or bifurcated (46%) gluteal folds and gluteal asymmetry (16%). Some asian groups have as high as 1 in 250 births with cleft, caucasians about. 2,4–6 Variations between practicing clinicians with respect to the management of. A total of 34 (24%) patients had an abnormal spinal US; 15 (44%. 5 cm above the anus) and solitary. 5cms from anal verge o Vascular lesion e. Body habitus may contribute to additional intertriginous sites, such as inframammary skin and. NO BIGGIE, unless it's really deep, which you didn't mention. Feb 4, 2023 at 3:55 PM. 604 Trauma to the skin, subcutaneous tissue and breast with mcc; 605 Trauma to the skin, subcutaneous tissue and breast without mcc; 963 Other multiple significant trauma. The patient has an unusual sacral crease and sacral dimple. Myalgia is pain in muscles, and since your Dr. Cleft Palate A cleft palate is a birth defect characterized by an opening in the roof of the mouth, caused by a lack of tissue development. A presumptive diagnosis was made of psoriasis, and the patient was given Elocon cream (Mometasone. Some authors tried to propose a higher threshold score based on the five-point scoring system, however, it did not increase sensitivity or specificity in the diagnosis of DST. nervous system sacral dimples Pediatrics in Review Vol. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. They communicate between the surface of the skin and deeper structures and may occur anywhere along the craniospinal axis. Cleft lip in the presented case - newborn of 4 days old. All newborns undergo an examination of the. To assess the clinical and economic consequences of different diagnostic strategies in newborns with suspected occult spinal dysraphism. little man has a duplicated gluteal cleft. Bust get. Spina Bifida Occulta (Occult Spinal Dysraphism) Spina bifida occulta is a common anomaly consisting of a midline defect of the vertebral bodies without protrusion of the spinal cord or meninges. The most common cutaneous manifestations were duplicated or bifurcated (46%) gluteal folds and gluteal asymmetry (16%). Figure 4. Collapse all. At 2 week app pediatrician said baby has a y shaped butt crack which could be a indicator of spina bifida or tethered cord. Code. ICD-10-CM Coding Rules. Intergluteal cleft Gluteal Fold Gluteal Sulcus Iliac Crest Dimple for. ) (gestational age 40 weeks, birth weight 3460 g, length 54 cm) The female patient was transferred for spinal sonography at the age of 5 days due to an asymmetrical gluteal crease. Congenital dermal sinuses represent cutaneous depressions or tracts that are lined by stratified squamous epithelium. Q82. It is also called butt crack or ass crack. They are a rare type of ear deformities. Expert solutions. Infants with a simple sacral dimple, with evidence of abnormal neurologic or orthopedic exam findings should be further evaluated F. The 2024 edition of ICD-10-CM Q82. Perianal tinea is uncommon. 156 Other ear, nose, mouth and throat. Pediatricians have been comfortable with assessing as insignificant the common low-lying midline dimple or deviated gluteal folds found at the nursery or first well-infant examination. 419 became effective on October 1, 2023. 5 may differ. Ems0. Causes. [2–4] These syndromes are all associated with median lip and/or mandibular clefts and digital variations. They are not harmful to one’s health and do not necessitate. Some of the lesions had a raised hyperkeratotic border, whereas others were scaly and/or erosive (Fig. 4%) presented with isolated markers (200 with solitary dimples, 6 with deviated or duplicated gluteal furrows, four with cutaneous masses, and one with hypertrichosis). ICD 9 Code: 685. The literature reports median tongue clefts only to be associated with orofacial digital syndromes type I, II, IV and VI. Sign in to MyChart. The primary intertriginous skin areas include the groin folds, axillae, and gluteal cleft. Q35. Most patients are asymptomatic and lack neurologic signs, and the condition is usually of no consequence. Duplicated gluteal crease. 02) and (2) deviated gluteal crease (P = . Skin stigmata were classified into seven types, dimple, deformed gluteal cleft, hair, subcutaneous mass, appendage, discoloration, and protruding bone, and included 1056 isolated and 199 complex ones. This means that the butt crack will appear off-center. Of course google isn’t my friend and everything I’m reading mentions a tethered spinal cord. Figure 4. Code. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code Q76. Congenital dermal sinus form due to a focal failure of dysjunction between the cutaneous ectoderm and. 2, 3 It is most commonly encountered in young men in their 20s and 30s, although women can also be affected. Congenital dermal sinus is an uncommon form of cranial or spinal dysraphism. Pathology showed squamous cell carcinoma with tumor-free margins, and further imaging showed no evidence of. g. A bifid uvula may be an isolated finding or it may be related to submucous cleft palate. info@flourishpaediatrics. 8%. Venus dimples are two dimples that appear on the lower back, just above the gluteal cleft. Motor/sensory grossly normal. Other perianal infectionsHad our first well check today and scheduled an ultrasound. Q36. 8 - other international versions of ICD-10 Q63. Perianal candidal intertrigo presents as soreness and irritation with bright red erythema and satellite lesions extending into the natal cleft. ), and relevant articles were selected by mutual agreement. 5 cm above the anus) and solitary. . Laceration of left buttock; Left buttock laceration; Stab wound of left buttock; ICD-10-CM S31. Congenital hip dislocation and bilateral club feet in an infant with Poland's anomaly. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. 5 - other international versions of ICD-10 P01. He seems completely healthy otherwise. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. This is the American ICD-10-CM version of Q63. Q79. Applicable To. Final. 3 The surgeon marks the standing patient. Each referred participant was risk stratified based on specific physical exam findings. There are many approaches to examining a newborn, many of which are acceptable. A prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. little man has a duplicated gluteal cleft. Feb 4, 2023 at 3:55 PM. 2-7. Ask parent/carer how the baby is feeding and if there has been any vomiting, and if so, what colour. The urethra is absent: A fibrous cord into the anterior wall of the rectum:. Results: Majority (80%) of infants had normal spinal US -Of the 20% of infants with abnormal spinal US that underwent spinal MRI only 5% had an abnormal spinal MRI -Neurosurgical consultation was documented for 13 infants with either abnormal US or MRI, of which only 2 required neurosurgical management for a tethered A dimple above the gluteal crease (the crease in the buttocks) Long hair (longer than 1 inch) growing on the back over the spine. 5 cm above the anus) and solitary. He did great & slept through the whole thing. 0 became effective on October 1, 2023. Codes mentioned in articles are linked to Code Information pages. Subcutaneous lipomas. The minimally invasive. The coccygeal region and anus are prepared with iodine or chlorhexidine. basically, the top of his bum crack. 86: Hydronephrosis: Coccygeal pit, Mongolian spot: CM ends at L2-3: N/A: N/A: Male/0. 2%. Expand all. It is designed by a fashion designer named Kimberly brewer. The vast majority of babies diagnosed with a laryngeal cleft are born with this condition. Pressure injuries, however, are ischemic injuries to the skin and underlying soft tissue that can result in full-thickness tissue damage. Minimize friction—dry the skin by patting, not rubbing, keeping in mind that friction is one of the causes. A cleft palate happens if the tissue that makes up the roof of the mouth does not join together completely during pregnancy. The 2022 edition of ICD-10-CM Q82. The authors gathered clinical illustrations of gluteal cleft wounds and conducted a literature search as a basis for presentation to conference attendees, with the goal of gaining consensus regarding guidelines for accurate classification of these wounds. A cross-sectional assessment of cutaneous lumbosacral and coccygeal physical examination findings in a. Tinea cruris is usually due to T. SGD patients developed with ulcer were all am-bulatory unlike the pressure sore. The universal screening picked up a type IIa DDH in 44. little man has a duplicated gluteal cleft. The gluteal region, commonly known as the buttocks or glutes, is the posterior part of the pelvic area. ”. basically, the top of his bum crack makes a y shape when. K62. Applicable To. 95. Sacral epidermal anomalies include dimples, tracts, lipomas, hemangiomas, and tufts of hair and may be associated with a neural tube defect, such as spina bifida. Cleft palate, unspecified. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Aju1985. non-midline lesion, forked gluteal cleft, coccygeal pit. 8% had deviated or duplicated gluteal creases, 15. Similar. Pathologic entities in the gluteal region reflect the diversity of tissue types present. Physical examination revealed a healthy appearing female with well-demarcated scaly pink plaques located in the gluteal cleft. 5 became effective on October 1, 2023. Q63. 1 Global variations in incidence have been reported, ranging from 0. Messages 1,130 Location Hibbing, MN Best answers 0. 0 - other international versions of ICD-10 Q36. 04%). 6%, and flat vascular macules in 1. Intertrigo is a superficial inflammatory dermatitis occurring on two closely opposed skin surfaces as a result of moisture, friction, and lack of ventilation. 419 - other international versions of ICD-10 M67. Mark: Sounds as though you may have developed a fissure, or something like it. Of 1096 infants included in the study, 24. The 2024 edition of ICD-10-CM Q82. Pilonidal disease is a clinical diagnosis based on history, physical exam (including anorectal exam), and evaluation of symptoms and risk factors. Not Included Here. 0):. 1). I never thought to bring it up to the doctor until recently when my mom said it’s not normal. 5 cm above the anus) and solitary. Lumbosacral and/or coccygeal hairiness could be found in some neonates, together with dimples and deviated or duplicated gluteal creases, which may be insignificant findings in low-risk newborns. 6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 6 may differ. Because most studies on gluteal cleft shaving have used an arbitrary manner and method, effective frequency and extent of shaving have not been systematically studied. Y Gluteal Cleft Baby. It is estimated that 2% to 4% of all newborns will have a sacral dimple. and E. Mild distension is normal in the first 24 h, as long as the abdomen is soft, the baby hasThe gluteal cleft was asymmetrical. According to his pediatrician it was only done out of an abundance of caution and typically there are two or more markers for spina bifida. Gluteal cleft is the vertical partition which separates buttocks. It occurs in 1 in 2500 live births. 5 may differ. Applicable To. Asymmetrical buttock creases can suggest hip dysplasia in infants but, like a hip click, an ultrasound or x-ray study will need to be done to determine whether the hips are normal or not. Fig. This is the American ICD-10-CM version of Q82. Visited with specialists to better understand her asymmetrical duplicated gluteal cleft, lumbar hemangioma, and then a CT and swallow study to help us figure out her NeuroEndocrine Cell Hypoplasia of Infancy. Distal portions of all three major structures enter what is known as the femoral triangle, found within the anterior proximal portion of the femoral region. 1%) had normalized, 16% were confirmed as type IIa, and 0. The rotating of tissue causes the gluteal cleft to shift. In newborns, the diagnosis is very ambiguous due to physiologic instability originating from the inborn laxity. The buttocks can be the most susceptible place boils for two reasons. Gluteal tendinitis; Gluteal tendonitis. Had our first well check today and scheduled an ultrasound. 8 is a billable diagnosis code used to specify a medical diagnosis of other specified congenital malformations of skin. Laterality will need to be indicated another way. basically, the top of his bum crack makes a y shape…Had our first well check today and scheduled an ultrasound. Although the literature suggests clinical consensus regarding some lumbosacral findings (simple dimples or slate gray macules), expert recommendations vary regarding the management of other findings (duplicated gluteal clefts or coccygeal or sacral hair). basically, the top of his bum crack makes a y shape…Q82. In newborns, the diagnosis is very ambiguous due to physiologic instability originating from the inborn laxity. Had our first well check today and scheduled an ultrasound. A laryngeal cleft (or laryngotracheal cleft) is an abnormal opening between the larynx and the esophagus through which food and liquid can pass through the larynx into the lungs. After completing this article, readers should be able to: Neural tube defects are among the most common forms of birth defect, affecting 1 in every 1,000 pregnancies. Doing the examination with parents present allows them to ask questions and allows the clinician to point out physical findings and provide anticipatory guidance. 6 became effective on October 1, 2023. Bodily secretions. What an incredible first year. They can rule out a tethered spinal cord for her through an MRI when she is older. The gluteal cleft of the left twin (black arrowhead) and the three lower. 1). The. Cute vs. 8%. Q92. and E. It is decorated from the upper side with rhinestones and colorful studs. 2 deletion. a. 1, 7, 8 Radiographic evaluations in infants under 4 months of age are also reported to be unreliable. 9 may differ. g. The key factors in performing this procedure are to flatten the entire gluteal cleft, remove all active pilonidal disease, and position. This could be a sign of a spinal cord tether, spinabifida etc. The code is exempt from present on admission (POA) reporting for. There are several names for this area: natal cleft, gluteal crease, gluteal crevice. 02). Download MyChart to connect with your care team. ASSESSMENT/PLAN: 2 day old with normal growth and development. Characteristic features include short intergluteal cleft, flattened buttocks, narrow hips, distal leg atrophy, and talipes deformities. Apr 24, 2016 at 7:40 PM. • Gluteal cleft anomalies other than dimples also have a weak association with milder forms of OSD and warrant further evaluation. Babies with congenital hip dislocation can also have asymmetrical gluteal folds. Anus opening absent, gluteal cleft, and anal dimple not well developed. Prevention. teal cleft than pressure sore which happen due to force abrasively folded inward in both buttocks (Fig. 5 cm from anus • Less than 5 mm diameter • Localized in gluteal cleftThe initial examination within the first 24 hours of birth is critical in determining newborn patients' general well-being and identifying any red flags that may warrant further evaluation. After reviewing the case, we decided to design the inferior flap as a laterally. If the base could not be seen, this would be called a coccygeal pit. Had our first well check today and scheduled an ultrasound. Keep the skin of the diaper area clean and dry. Linear lesions in the intergluteal cleft are caused by moisture with or without a friction component and should be classified as intertriginous (between skin folds) dermatitis (inflammation of the skin). 중복 엉덩이 틈새 (duplicated gluteal cleft)로 OSD와 연관되어 있어요. • Subcutaneous mass or lipoma (sometimes seen as deviation of gluteal fold) • Hairy patch • Dermal sinus ( Sinuses opening onto skin surface, located above gluteal cleft and have a cephalically oriented tract) • Atypical Dimples : o Deep (>5mm) o >2. It is decorated from the upper side with rhinestones and colorful studs. The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). Dermal sinus tracts are different from innocuous coccygeal dimples, which are located lower within the gluteal cleft and are not associated with cutaneous stigmata; completely “classic” dimples do not require further workup or follow-up. Then, the surgical wound is closed by rotating other tissue to cover the area. In the pressure ulcer, the most important etiologic factor is pressure. This condition is. Pilonidal literally means a “nest of hair. 1 The underlying cause of pilonidal disease is. tenderness. Answer: Sacaral dimple. The patient is intubated on a sterile draw. Sacral dimple newborn – a prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. She has had RSV, Brinchiolitis, surgery to detether her Tethered Spinal cord. 0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 34 may differ. May 2020; Hospital Pediatrics 10(6)The cutaneous areas along the gluteal cleft and sulcus were likely to be supplied by 3 routes: 1) the internal pudendal artery (IPA), especially its first cutaneous branch; 2) perforators running through the gluteus maximus muscle and arising from the inferior gluteal artery (IGA); and 3) a non-perforator running around and inferior to the. 0. 5 cm; (3) located within the superior portion of the gluteal crease or above (greater than 2. Q82. 9 - other international versions of ICD-10 Q37. Page 1 and 2: March 13 th 2012; Page 4 and 5: • Vitals: 36. Physical examination findings that prompted a spinal ultrasound included isolated deep sacral dimple (34%); deep sacral dimple in association with other. A prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. 0 Central cleft lip 749. They did an ultrasound of his booty & spine when he was like a week old. A crooked crease between the buttocks. 8 - other international versions of ICD-10 Q63. 1 may differ. Oct 16, 2008 #2 you're joking right? ? M. Re: Upper gluteal cleft (buttcrack) is bleeding. little man has a duplicated gluteal cleft. I never thought to bring it up to the doctor until recently when my mom said it’s not normal.