Oralfacial development

Question 1

When does central face development begin?

Answer 1

• week 4
• nasal placode develops
• proliferation of ectomesnehcyme on both sides of each placed results in medial and lateral nasal processes

Question 2

When does the upper lip begin development?

Answer 2

• week 6-7

- medial nasal processe merge with each other as well as the maxillary processes of the first brachial arches

Question 3

How is the primary palate formed?

Answer 3

• merge of the medial nasal process

Question 4

How does the secondary palate form?

Answer 4

• formed from the maxillary processes of the first branchial arches
• makes up 90% of the hard and soft palate
  MEDIAL NASAL PROCESSE FORM THE PRIMARY PALATE, NOT THE PALATAL SHELVES

Question 5

What is cleft lip?

Answer 5

• defective fusion of the medial nasal process with the maxillary process
• 80% of cases are unilateral
• Rule of 10: 10wks, 10lbs, 10% HM

Question 6

What is cleft palate?

Answer 6

• failure of palate shelves to fuse
• the minimal manifestation of CP is bifid uvula
• treatment about 1.5 y.o.

Question 7

What are percent of CL and CP?

Answer 7

• 45% are CL and CP
• 30% are CP
• 25% are CL

Question 8

What causes non syndromic CP?

Answer 8

• alcohol or cig. abuse
• folic acid deficiency
• corticosteroid use
• anticonvulsant therapy

Question 9

What is lateral facial cleft?

Answer 9

• lack of fusion of the Max. and Mand. processes

Question 10

What is oblique facial clefts?

Answer 10

• Failure of fusion of the lateral nasal processes with Max. process
• Upper lip to eye
• almost always associated with CP

Question 11

What is meidan cleft of the upper lip?

Answer 11

• failure of fusion of the medial nasal processes, vary rare

Question 12

What is the prevalence of orofacial cleating?

Answer 12

• natives: 1/250
• asians: 1/300
• whites: 1/700
• blacks: 1/1500
• CL+/- cp more common in males
• CPO is more common in females

Question 13

What is sub mucous palate cleating?

Answer 13

• surface intact, but defect exist in the underlying musculature of the soft palate
• a bone notch will be present on the post. hard palate margin
• appears as a bluish midline discoloration

Question 14

What are commissural lip pits?

Answer 14

• mucosal invaginations that occur at the corner of the mouth on the vermillion boarder
• not associated with facial or palatal clefts

Question 15

What are per median lip pits?

Answer 15

• congenital invaginations of the lower lip
• usually bilaterally located
• no tx excepts for evaluation for syndrome

Question 16

What is Van der Woude syndrome?

Answer 16

• autosomal dominate
• CL +/- CP
• paramedian lip pits
• MOST COMMON FORM OF SYNDROMIC CLEFTING

Question 17

What is microglossia?

Answer 17

• abnormally small tongue, usually syndromic
• associated with hypoplasia of the mandible
• lower incisors may be missing
• treatment depends on nature and severity of condition

Question 18

What is aglossia?

Answer 18

• Entire tongue missing

Question 19

What is ankyloglossia?

Answer 19

• short, thickened lingual frenum; tongue tied
• may cause problems with speech and breast feeding
• no treatment if asymptomatic
  
  • frenotomy or frenuloplasty

Question 20

What is lingual thyroid?

Answer 20

• during week 7 thyroid band descend into the neck
  
  • ant. to trachea and larynx
  • foramen cecum
• If primitive gland doesn’t descend normally, ectopic thyroid can be found between the foramen cecum and the epiglottis
• 7x more common in females
• Symptoms: dysphagia, dysphoria, dyspnea
• presents as nodule on post. tongue, midline
• 1/3 have hypothyroidism

Question 21

What is a thyroglossal duct cyst?

Answer 21

• develop from epithelia remnants of the thyroglossal tract
• 50% are diagnosed before age 20
• presents as a painless, fluctuant, moveable swelling at or near midline, usually inf. to the hyoid bone
• Tx ; surgical removal; 10% recurrence

Question 22

What is Hemihyperplasia?

Answer 22

• asymmetric overgrowth of one or more body parts

- unilateral macroglossia

Question 23

What is Crouzon syndrome?

Answer 23

• characterized by craniosynostosis (premature closing of the cranial sutures)
• ‘clover leaf’ skull
• ocular proptosis, under developed maxilla
• beaten-metal pattern on x-ray

Question 24

What is Apart syndrome?

Answer 24

• ocular proptosis
• hypertelorism
• downward slant lateral palpebral fissures
• syndical of digits
• Mental retardation
• Oral: trapezoid shape to lips