Morphologic Adaptations Secondary to the Production of Experimental Cleft Palate in Primates

Abstract

Many problems in the multidimensional treatment of cleft palate have their basis in the specific malformation and dysfunction presented by the individual patient. These factors are the resultant expression of both the abnormality in development and the malposition of the affected parts. From early fetal life, the interrelationships of abnormality and mal-position result in the characteristic, yet variable, appearance of the child with cleft palate. These characteristics have been carefully described in several significant studies which have contributed to an understanding of the nature of the deformity and subsequently to improved treatment. Among these investigations were the early studies of Graber (4). His research indicated that the growth of the maxilla in cleft lip and palate patients was deficient in all dimensions: lateral, anteroposterior, and vertical. He drew attention to the importance of proper timing and technique in surgical treatment. Snodgrasse (12) analyzed various facial characteristics and concluded that, in addition to reduced midface development, the size and position of the mandible were less than expected. Harvold (7) found facial asymmetry in the upper jaw, including the nasal septum and the position of the anterior nasal spine and alveolar process. He detected no significant asymmetry beyond the maxillary complex and attributed the important part of the cleft palate deformity to the change in position and shape of the maxillary segments. Pruzansky (10) pointed to the beneficial narrowing which occurs along the cleft when normal muscle action is restored.