Talk:Abnormal Development - Cleft Palate
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Cite this page: Hill, M.A. (2024, June 15) Embryology Abnormal Development - Cleft Palate. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Abnormal_Development_-_Cleft_Palate |
2013
Is there an optimal resting velopharyngeal gap in operated cleft palate patients?
Indian J Plast Surg. 2013 Jan;46(1):87-91. doi: 10.4103/0970-0358.113716.
Yellinedi R1, Damalacheruvu MR.
Abstract CONTEXT: Videofluoroscopy in operated cleft palate patients. AIMS: To determine the existence of an optimal resting velopharyngeal (VP) gap in operated cleft palate patients. SETTINGS AND DESIGN: A retrospective analysis of lateral view videofluoroscopy of operated cleft palate patients. MATERIALS AND METHODS: A total of 117 cases of operated cleft palate underwent videofluoroscopy between 2006 and 2011. The lateral view of videofluoroscopy was utilised in the study. A retrospective analysis of the lateral view of videofluoroscopy of these 117 patients was performed to analyse the resting VP gap and its relationship to VP closure. STATISTICAL ANALYSIS USED: None. RESULTS: Of the 117 cases, 35 had a resting gap of less than 6 mm, 34 had a resting gap between 6 and 10 mm and 48 patients had a resting gap of more than 10 mm. CONCLUSIONS: The conclusive finding was that almost all the patients with a resting gap of <6 mm (group C) achieved radiological closure of the velopharynx with speech; thus, they had the least chance of VP insufficiency (VPI). Those patients with a resting gap of >10 mm (group A) did not achieve VP closure on phonation, thus having full-blown VPI. Therefore, it can be concluded that the ideal resting VP gap is approximately 6 mm so as to get the maximal chance of VP closure and thus prevent VPI. KEYWORDS: Resting gap; cleft palate; velopharyngeal incompetence; videofluoroscopy
PMID 23960311 PMCID: PMC3744913
velopharyngeal insufficiency (VPI) - occurs when the velum and lateral and posterior pharyngeal walls fail to separate the oral cavity from the nasal cavity during speech.
Table 1 :Neuromeric origins and developmental field defects of the Tessier craniofacial clefts
Tessier Zone | Neuromere Origin | Developmental Field | Neurovascular Supply |
---|---|---|---|
0 | n/a | fusion failure
n/a | |
1 | r2’ | premaxilla- central incisor | medial sphenopalatine |
2 | r2’ | premaxilla-central, lateral incisors/frontal process | medial sphenopalatine |
3 | r2 | maxilla, palatine bone, inferior turbinate | lateral sphenopalatine |
4 | r2 | ||
5 | r2 | ||
6 | r2 | ||
7 | r2 | ||
8 | r2 | ||
9 | alisphenoid | middle meningeal, anterior deep temporal | r2 |
10 | p5 | postfrontal | supraorbital |
11 | p5, r1 | prefrontal, lacrimal | supratrochlear, dorsal nasal |
12 | p5, r1 | ethmoid labryinth | anterior/posterior ethmoid, lateral nasal branches |
13 | p5, r1 | ethmoid cribiform | anterior/posterior ethmoid, medial nasal branches |
14 | n/a | fusion failure | n/a |
2008
Palatoplasty: evolution and controversies
Chang Gung Med J. 2008 Jul-Aug;31(4):335-45.
Leow AM1, Lo LJ.
Abstract
Treatment of cleft palate has evolved over a long period of time. Various techniques of cleft palate repair that are practiced today are the results of principles learned through many years of modifications. The challenge in the art of modern palatoplasty is no longer successful closure of the cleft palate but an optimal speech outcome without compromising maxillofacial growth. Throughout these periods of evolution in the treatment of cleft palate, the effectiveness of various treatment protocols has been challenged by controversies concerning speech and maxillofacial growth. This article reviews the history of cleft palate surgery from its humble beginnings to modern-day palatoplasty, and describes various palatoplasty techniques and commonly used modifications. Current controversial issues on the timing of cleft palate repair, and the effects on speech and maxillofacial growth are also discussed. PMID 18935791