Embryological Development of Face PDF

**Embryological development of face** Embryological disorders affecting the lip and palate are common conditions that often require surgical correction. A solid understanding of facial structure development and the primary types of cleft lip and palate anomalies is crucial for effectively addressin...

**Embryological development of face** Embryological disorders affecting the lip and palate are common conditions that often require surgical correction. A solid understanding of facial structure development and the primary types of cleft lip and palate anomalies is crucial for effectively addressing these disorders and their implications in clinical practice. The facial primordia appear in the fourth week around the stomodeum. The five facial primordia are: - The frontonasal prominence - The maxillary prominences (paired) - The mandibular prominences (paired) They are active centres of growth and the face develops mainly between weeks 4 and 8. Nasal placodes (the primitive nose and nasal cavities) develop in the frontonasal prominence by the end of week 4. The mesenchyme around the placodes proliferates to form elevations -- the medial and lateral nasal prominences. The maxillary prominences proliferate and grow medially towards each other. This pushes the medial nasal placodes into the midline. A groove is formed between the lateral nasal prominence and the maxillary prominence and the two sides of these prominences merge by the end of week 6. As the medial nasal prominences merge they give rise to the intermaxillary segment. This develops into the philtrum of the upper lip, septum of the premaxilla, and the primary palate and nasal septum. The maxillary prominences form the upper cheek and most of the upper lip, whereas the mandibular prominences give rise to the chin, lower lip and lower cheek region. **Development of the palate** The palate formation occurs between weeks 5 and 12, originating from both the primary and secondary palates. The primary palate arises from the intermaxillary segment\'s deep area of the maxilla during the fusion of the medial nasal prominences, contributing only a small section to an adult\'s palate. The secondary palate develops the hard and soft palates through the lateral palatine processes that arise from the inner areas of the maxillary prominences. These processes converge and unite at the midline, together with the nasal septum and the posterior section of the primary palate.  **Cleft lip and palate can be categorized into two main types:** - Those affecting the upper lip and the front part of the maxilla, potentially extending to parts of the remaining hard and soft palate regions. - Those affecting the hard and soft palate regions. It is believed that there is a genetic component to cleft lip and palate. While teratogenic factors are largely unidentified, a deficiency in vitamin B complex during pregnancy may play a causative role. The likelihood of having a second child with the condition is 4%, compared to 0.1% in the overall population. **Primary management** [Antenatal diagnosis and counselling] - All but isolated cleft palate can be diagnosed by ultrasound scan after 18 weeks' gestation - Parents will need counselling and support [Problems immediately after birth] - Some babies are able to feed normally but some will need assistance - Breathing problems in Pierre Robin sequence may be life threatening [Principle of surgery ] The primary objective in managing cleft lip and palate is to achieve a patient with a typical appearance of the lip, nose, and face, with normal speech, and whose dental and facial growth are within the bounds of typical development.