Talk:Abnormal Development - Cleft Palate
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Cite this page: Hill, M.A. (2024, May 4) Embryology Abnormal Development - Cleft Palate. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Abnormal_Development_-_Cleft_Palate |
2015
Molecular basis of cleft palates in mice
World J Biol Chem. 2015 Aug 26;6(3):121-38. doi: 10.4331/wjbc.v6.i3.121.
Funato N1, Nakamura M1, Yanagisawa H1.
Abstract Cleft palate, including complete or incomplete cleft palates, soft palate clefts, and submucosal cleft palates, is the most frequent congenital craniofacial anomaly in humans. Multifactorial conditions, including genetic and environmental factors, induce the formation of cleft palates. The process of palatogenesis is temporospatially regulated by transcription factors, growth factors, extracellular matrix proteins, and membranous molecules; a single ablation of these molecules can result in a cleft palate in vivo. Studies on knockout mice were reviewed in order to identify genetic errors that lead to cleft palates. In this review, we systematically describe these mutant mice and discuss the molecular mechanisms of palatogenesis. KEYWORDS: Incomplete cleft palate; Knockout mice; Palatal shelf; Palatogenesis; Submucosal cleft palate; Tbx1
PMID 26322171
Global Birth Prevalence of Orofacial Clefts: A Systematic Review
J Med Assoc Thai. 2015 Aug;98 Suppl 7:S11-21.
Panamonta V, Pradubwong S, Panamonta M, Chowchuen B.
Abstract
BACKGROUND: A birth prevalence of orofacial clefts (OFCs) worldwide has been documented to vary. However a systematic assessment is lacking. OBJECTIVE: To assess the evidence in the literature for the birth prevalence of OFCs. MATERIAL AND METHOD: A systematic literature search was conducted using electronic databases through PubMed between 1950 and June 2015 using key words and search terms of cleft lip palate OR orofacial cleft AND prevalence. RESULTS: There were 45,193 patients with OFCs found in a study population of 30,665,615 live births. According to continents, the OFC birth prevalence (95% confidence interval)from Asia, North America, Europe, Oceania, South America, and Africa were 1.57 (1.54-1.60), 1.56 (1.53-1.59), 1.55 (1.52-1.58), 1.33 (1.30-1.36), 0.99 (0.96-1.02), and 0.57 (0.54-0.60) per 1,000 live births, respectively. The American Indians had the highest prevalence rates of 2.62 per 1,000 live births, followed by the Japanese, the Chinese, and the Whites of 1.73, 1.56, and 1.55 per 1,000 live births, respectively. The Blacks had the lowest rate of 0.58 per 1,000 live births. CONCLUSION: Observed differences may also be of ethnic origin, genetic, environmental factors, and methods of ascertainment. Further investigations are needed to manage this global health problem. PMID 26742364
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
