cleft notes

Development of the primitive mouth and nose.

Stomodeum

Develops into the nose, the central part of the upper lip, and the primary palate.

Frontonasal Process

Forms most of the face, mouth, cheeks, and the sides of the upper lip: most of the hard palate; the alveolar ridge; and the soft palate.

Maxillary Process

Gives rise to the lower jaw (mandible), lower lip, and chin— all formed and fused by the end of the 4th or 5th week.

Mandibular Process

Facial structures begin forming, including the nasal and maxillary processes. Cleft lip can occur here, but the palate hasn't developed yet. Face starts forming, but the palate hasn't developed yet.

• Week 4-6

• Week 6-8

• Weeks 7-10

• Weeks 10-12

Week 4-6

Palatal shelves form but remain vertical on either side of the tongue. The lip is fusing, but the palate isn't in position yet. Palatal shelves form but stay vertical; lip fuses during this time.

• Week 4-6

• Week 6-8

• Weeks 7-10

• Weeks 10-12

Weeks 6-8

The palatal shelves rotate, move toward the midline, and fuse with each other and the nasal septum. Disruptions here lead to cleft palate. Palatal shelves flip op, move to midline, and tuse with the nasa septim.

• Week 4-6

• Week 6-8

• Weeks 7-10

• Weeks 10-12

Weeks 7-10

Fusion is complete, and the hard palate starts ossifying. If clefting occurs now, it's usually a submucous cleft. Fusion is done, and the hard palate starts turning into bone.

• Week 4-6

• Week 6-8

• Weeks 7-10

• Weeks 10-12

Weeks 10-12

unilateral incomplete

bilateral complete and incomplete

bilateral complete

unilateral complete

complete bilateral

complete unilateral

incomplete hard and soft palate

submucosal cleft

incomplete of soft palate only

The most common syndrome linked to cleft palate, causing hypernasal speech and difficulty building oral pressure for sounds.

Velocardiofacial Syndrome

Characterized by a small jaw (micrognathia), tongue falling back (glossoptosis), airway obstruction, and a U-shaped cleft palate, making feeding and breathing harder.

Pierre Robin Sequence

Affects facial bone development, leading to a small lower jaw (mandibular hypoplasia) and often a cleft or high-arched palate, which impacts feeding and speech.

Treacher Collins Syndrome

Often linked to Pierre Robin Sequence, featuring cleft palate, joint laxity, vision issues, and midface hypoplasia, all contributing to feeding and articulation challenges

Stickler Syndrome