Oralfacial development Flashcards
When does central face development begin?
- week 4
- nasal placode develops
- proliferation of ectomesnehcyme on both sides of each placed results in medial and lateral nasal processes
When does the upper lip begin development?
- week 6-7
- medial nasal processe merge with each other as well as the maxillary processes of the first brachial arches
How is the primary palate formed?
- merge of the medial nasal process
How does the secondary palate form?
- 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
What is cleft lip?
- defective fusion of the medial nasal process with the maxillary process
- 80% of cases are unilateral
- Rule of 10: 10wks, 10lbs, 10% HM
What is cleft palate?
- failure of palate shelves to fuse
- the minimal manifestation of CP is bifid uvula
- treatment about 1.5 y.o.
What are percent of CL and CP?
- 45% are CL and CP
- 30% are CP
- 25% are CL
What causes non syndromic CP?
- alcohol or cig. abuse
- folic acid deficiency
- corticosteroid use
- anticonvulsant therapy
What is lateral facial cleft?
- lack of fusion of the Max. and Mand. processes
What is oblique facial clefts?
- Failure of fusion of the lateral nasal processes with Max. process
- Upper lip to eye
- almost always associated with CP
What is meidan cleft of the upper lip?
- failure of fusion of the medial nasal processes, vary rare
What is the prevalence of orofacial cleating?
- natives: 1/250
- asians: 1/300
- whites: 1/700
- blacks: 1/1500
- CL+/- cp more common in males
- CPO is more common in females
What is sub mucous palate cleating?
- 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
What are commissural lip pits?
- mucosal invaginations that occur at the corner of the mouth on the vermillion boarder
- not associated with facial or palatal clefts
What are per median lip pits?
- congenital invaginations of the lower lip
- usually bilaterally located
- no tx excepts for evaluation for syndrome
What is Van der Woude syndrome?
- autosomal dominate
- CL +/- CP
- paramedian lip pits
- MOST COMMON FORM OF SYNDROMIC CLEFTING
What is microglossia?
- abnormally small tongue, usually syndromic
- associated with hypoplasia of the mandible
- lower incisors may be missing
- treatment depends on nature and severity of condition
What is aglossia?
- Entire tongue missing
What is ankyloglossia?
- short, thickened lingual frenum; tongue tied
- may cause problems with speech and breast feeding
- no treatment if asymptomatic
- frenotomy or frenuloplasty
What is lingual thyroid?
- 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
What is a thyroglossal duct cyst?
- 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
What is Hemihyperplasia?
- asymmetric overgrowth of one or more body parts
- unilateral macroglossia
What is Crouzon syndrome?
- characterized by craniosynostosis (premature closing of the cranial sutures)
- ‘clover leaf’ skull
- ocular proptosis, under developed maxilla
- beaten-metal pattern on x-ray
What is Apart syndrome?
- ocular proptosis
- hypertelorism
- downward slant lateral palpebral fissures
- syndical of digits
- Mental retardation
- Oral: trapezoid shape to lips
