Clefts of the upper lip and of the hard and soft palates are so common as to be almost routine in any large surgical clinic. Medial clefts of the chin, however, are extremely rare. No mention is made of these in most of the standard textbooks of surgery.
The case reported in this paper is one that came under the care of the State Crippled Children's Service, University Hospitals, Columbia, Mo. A child 3 days old was admitted who had a complete cleft of the lower lip and mandible extending almost down to the cricoid cartilage, with a bifid tongue as a complicating feature.
Etiologically, median clefts of the lower lip represent arrested development due to failure of union of the two inferior portions of the first branchial arch. The clefts may be simple, involving only a portion of the lip, or may extend completely down the midline to include