Development of the Palate: Abnormalities – Primary and Secondary Palate Development

by John McLachlan, PhD

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    00:01 So here are some babies with a variety of primary and secondary palate conditions and you can imagine readily that what happened here is that this very precise series of timings which are required in normal development, in some way, have gone astray, and that needs to be really quite small changes that can bring about major failures. And there are some set lines of failures, which we can expect to see during this process. This is a relatively common abnormality to observe in development, and it can range between one in 700 and one in 2,000 live births. So it means this is a significant contributor to the total number of abnormalities. One thing that we must bear in mind is that there’s a significant emotional impact even beyond the difficulties in the function which have been evoked by this condition.

    00:51 It’s because human respond emotionally to faces in a way that they don’t do to other internal organs in the body. However, there may be real practical difficulties, and this can take the form of difficulties in feeding, particularly in suckling in the early stages, difficulties in breathing because there’s inadequate separation between the trachea and the oesophagus, and of course difficulties in speaking. The absence or disturbance of the palate means that forming sounds may be much more difficult. In combination, these difficulties are significant. The process can be surgically corrected, but the earlier the correction takes place, then the more complete and neater healing will be.

    01:36 This is something that has been explored for the possibility of operating in the uterus before the baby is born, although that in itself poses significant hazards. You can imagine that any of the lines of contact can give rise to particular difficulties. So we can see in the various diagrams some of the combinations that you might expect. In diagram A, what we can see is unilateral that is one-sided cleft lip, and that’s associated with the unilateral cleft of the primary palate separating the primary palate from the secondary palate.

    02:14 In B, we can see a bilateral primary cleft palate and cleft lip. Image C shows secondary cleft palate on its own. And image D shows bilateral primary cleft palate and cleft lip along with secondary cleft palate, the most serious combination that you could get.

    02:37 However, there is a variety of other abnormalities that can affect the head and neck and face.

    02:43 Some of these are defined as first arch syndromes, as they affect the derivatives of the first pharyngeal arches and also the associated pouches and grooves. This means that it’s easy to affect the external ears, the mandible, and the palate. This may result from insufficient migration of neural crest cells into the arch, and this in turn is under the influence of genetic components. Two examples are Treacher Collins and Pierre Robin syndromes.

    About the Lecture

    The lecture Development of the Palate: Abnormalities – Primary and Secondary Palate Development by John McLachlan, PhD is from the course System-Specific Embryology with John McLachlan.

    Author of lecture Development of the Palate: Abnormalities – Primary and Secondary Palate Development

     John McLachlan, PhD

    John McLachlan, PhD

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