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Journal of Medical Ultrasound 2024Orofacial clefts (OFCs), including cleft lip (CL), cleft palate (CP), and CL with palate (CL/P), are relatively common congenital birth defects occurring in... (Review)
Review
Orofacial clefts (OFCs), including cleft lip (CL), cleft palate (CP), and CL with palate (CL/P), are relatively common congenital birth defects occurring in approximately 1 in 500 to 1 in 2500 live births. Detecting OFCs during prenatal ultrasound screening is crucial for informed decision-making and multidisciplinary medical care. This review provides a practical guide for routine and advanced screening for OFCs during mid-pregnancy. The Maarse classification system facilitates effective communication among the multidisciplinary team, categorizing OFCs into five types. Basic ultrasound views encompass coronal, sagittal, and axial imaging of the face and hard palate. Additional visualization techniques are employed in case of suspected anomalies during the initial screening. Advanced ultrasound views provided by the expert in prenatal OFC diagnosis include imaging of the posterior edge of the hard palate and the posterior part of the soft palate. Detected OFCs exhibit a range of severity and affect different structures, underscoring the importance of accurate detection and classification for appropriate treatment planning. Implementing a standardized screening protocol for OFCs is essential. By enhancing detection rates and enabling early diagnosis, prenatal ultrasound screening contributes to improved patient outcomes and facilitates timely intervention by the multidisciplinary team. In conclusion, this review emphasizes the significance of standardized protocols and specialized techniques for prenatal ultrasound screening of OFCs. Early detection and classification of these malformations play a vital role in comprehensive management, ensuring that affected individuals and their families receive the appropriate care and support they need.
PubMed: 38665338
DOI: 10.4103/jmu.jmu_123_23 -
PloS One 2018People vary at most levels, from the molecular to the cognitive, and the shape of the hard palate (the bony roof of the mouth) is no exception. The patterns of variation...
People vary at most levels, from the molecular to the cognitive, and the shape of the hard palate (the bony roof of the mouth) is no exception. The patterns of variation in the hard palate are important for the forensic sciences and (palaeo)anthropology, and might also play a role in speech production, both in pathological cases and normal variation. Here we describe a method based on Bézier curves, whose main aim is to generate possible shapes of the hard palate in humans for use in computer simulations of speech production and language evolution. Moreover, our method can also capture existing patterns of variation using few and easy-to-interpret parameters, and fits actual data obtained from MRI traces very well with as little as two or three free parameters. When compared to the widely-used Principal Component Analysis (PCA), our method fits actual data slightly worse for the same number of degrees of freedom. However, it is much better at generating new shapes without requiring a calibration sample, its parameters have clearer interpretations, and their ranges are grounded in geometrical considerations.
Topics: Computer Simulation; Humans; Magnetic Resonance Imaging; Models, Anatomic; Palate, Hard; Principal Component Analysis
PubMed: 29447175
DOI: 10.1371/journal.pone.0191557 -
Swiss Dental Journal May 2018
Topics: Cone-Beam Computed Tomography; Gutta-Percha; Humans; Imaging, Three-Dimensional; Lasers, Gas; Male; Middle Aged; Nasal Cavity; Palate, Hard; Radiography, Dental, Digital
PubMed: 29734802
DOI: No ID Found -
Acta Ophthalmologica May 2017To evaluate the histological appearances of the epithelial cells and the clinical effect of the hard palate mucous membrane (HPM) graft for the treatment of lower eyelid...
PURPOSE
To evaluate the histological appearances of the epithelial cells and the clinical effect of the hard palate mucous membrane (HPM) graft for the treatment of lower eyelid retraction (LER).
METHODS
This was a follow-up study involving 15 patients, with a total of 16 eyes operated. Five patients had LER as a result of Graves' ophthalmopathy and/or inferior rectus recession, six patients because of wearing an eye prosthesis, two patients because of previous tumour excision, one patient because of proptosis due to sphenoid wing meningioma and one patient because of previous lower eyelid blepharoplasty. Three imprint biopsies were taken from each patient, one from the tarsal conjunctiva in the healthy eye, one from the graft in the operated eye and one from unoperated hard palate. The inferior scleral show was measured on pre- and postoperative photographs and related to the horizontal corneal diameter.
RESULTS
Median follow-up time was 21.2 [range 4.5-87.9] months. Imprints from the graft and the hard palate showed equally large epithelial cells; imprints from conjunctiva showed small epithelial cells. The mean (±SD) scleral show was 0.12 ± 0.09 cornea diameter before surgery and 0.0003 ± 0.08 cornea diameter at invited follow-up (p < 0.001, paired t-test). Corrected for direction of gaze, the mean improvement in scleral show was 0.12 ± 0.08 cornea diameter. Thirteen of 14 patients were satisfied with the final result.
CONCLUSION
A HPM graft for LER maintains its native epithelial morphology and gives a lasting improvement in most patients.
Topics: Adult; Aged; Biopsy; Blepharoplasty; Eyelid Diseases; Eyelids; Female; Follow-Up Studies; Humans; Male; Middle Aged; Mouth Mucosa; Palate, Hard; Retrospective Studies; Time Factors; Young Adult
PubMed: 27996195
DOI: 10.1111/aos.13321 -
Anatomical Record (Hoboken, N.J. : 2007) Feb 2009Morphological variation related to differential loading is well known for many craniomandibular elements. Yet, the function of the hard palate, and in particular the...
Morphological variation related to differential loading is well known for many craniomandibular elements. Yet, the function of the hard palate, and in particular the manner in which cortical and trabecular bone of the palate respond to masticatory loads, remains more ambiguous. Here, experimental data are presented that address the naturalistic influence of biomechanical loading on the postweaning development and structure of the hard palate. A rabbit model was used to test the hypothesis that variation in the morphology of the hard palate is linked to variation in masticatory stresses. Rabbit siblings were divided as weanlings into soft and hard/tough dietary treatment groups of 10 subjects each and were raised for 15 weeks until subadulthood. MicroCT analyses indicate that rabbits subjected to elevated masticatory loading developed hard palates with significantly greater bone area, greater cortical bone thickness along the oral lamina, and thicker anterior palates. Such diet-induced levels of palatal plasticity are comparable to those for other masticatory elements, which likely reflect osteogenic responses for maintaining the functional integrity of the palate vis-à-vis elevated stresses during unilateral mastication. These data support a role for mechanical loading in the determination of palatal morphology, especially its internal structure, in living and fossil mammals such as the hominin Paranthropus. Furthermore, these findings have potential implications for the evolution of the mammalian secondary hard palate as well as for clinical considerations of human oral pathologies.
Topics: Animals; Biological Evolution; Biomechanical Phenomena; Bite Force; Diet; Models, Animal; Osteogenesis; Palate, Hard; Phenotype; Rabbits; X-Ray Microtomography
PubMed: 19089904
DOI: 10.1002/ar.20840 -
Journal of Anatomy Feb 2022Hard palate consists anteriorly of the palatal process of the maxilla (ppmx) and posteriorly of the palatal process of the palatine (ppp). Currently, palatal...
Hard palate consists anteriorly of the palatal process of the maxilla (ppmx) and posteriorly of the palatal process of the palatine (ppp). Currently, palatal osteogenesis is receiving increasing attention. This is the first study to provide an overview of the osteogenesis process of the mouse hard palate. We found that the period in which avascular mesenchymal condensation becomes a vascularized bone structure corresponds to embryonic day (E) 14.5 to E16.5 in the hard palate. The ppmx and ppp differ remarkably in morphology and molecular respects during osteogenesis. Osteoclasts in the ppmx and ppp are heterogeneous. There was a multinucleated giant osteoclast on the bone surface at the lateral-nasal side of the ppmx, while osteoclasts in the ppp were more abundant and adjacent to blood vessels but were smaller and had fewer nuclei. In addition, bone remodeling in the hard palate was asymmetric and exclusively occurred on the nasal side of the hard palate at E18.5. During angiogenesis, CD31-positive endothelial cells were initially localized in the surrounding of palatal mesenchymal condensation and then invaded the condensation in a sprouting fashion. At the transcriptome level, we found 78 differentially expressed genes related to osteogenesis and angiogenesis between the ppmx and ppp. Fifty-five related genes were up/downregulated from E14.5 to E16.5. Here, we described the morphogenesis and the heterogeneity in the osteogenic and angiogenic genes profiles of the ppmx and ppp, which are significant for subsequent studies of normal and abnormal subjects.
Topics: Animals; Endothelial Cells; Maxilla; Mice; Morphogenesis; Osteogenesis; Palate; Palate, Hard
PubMed: 34569061
DOI: 10.1111/joa.13545 -
International Journal of Environmental... Mar 2021Mucosal melanomas of the head and neck region are uncommon pathologies that can affect the oral cavity, and are characterized by a high rate of mortality. Considering...
Mucosal melanomas of the head and neck region are uncommon pathologies that can affect the oral cavity, and are characterized by a high rate of mortality. Considering the lack of knowledge regarding risk and prognostic factors, current best clinical practice is represented by a large surgical excision with disease-free margins, eventually associated with a reconstructive flap. Indeed, given the frequent necessity of postoperative radiotherapy and fast healing process, a reconstruction of the surgical gap is advisable. Even if several flaps have been most commonly used, the submental island flap represents a valid alternative thanks to local advantages and similar oncologic outcomes compared to free flaps.
Topics: Head and Neck Neoplasms; Humans; Melanoma; Neck; Palate, Hard; Plastic Surgery Procedures; Retrospective Studies; Surgical Flaps
PubMed: 33804881
DOI: 10.3390/ijerph18073341 -
Cirugia Pediatrica : Organo Oficial de... Jul 2020Palate fistula is the most frequent complication following palatoplasty. The objectives of this study were: to describe the most widely used repair techniques; to study...
INTRODUCTION
Palate fistula is the most frequent complication following palatoplasty. The objectives of this study were: to describe the most widely used repair techniques; to study results and recurrence rate; to analyze potentially predictive recurrence variables; and to assess whether a specific technique is superior according to fistula size and location.
MATERIALS AND METHODS
Retrospective study of patients undergoing palate fistula repair in 7 healthcare facilities from 2008 to 2018. All facilities had at least 20 new cases of cleft lift and palate annually (range: 20-80), with a fistula incidence of 14% (range: 1.5-20%). Minimum follow-up was 1 year. 8 variables were collected for statistical analysis purposes.
RESULTS
234 fistula patients underwent surgery. Most fistulas occurred in complete bilateral cleft lift and palate (Veau type IV). The most frequent location was the hard palate (Pittsburgh types IV and V (63.2%)), and fistulas were mostly large (42.1%) and medium (39.5%). The most frequent repair technique was re-palatoplasty (34.2%). Recurrence rate was 22%. The multivariate analysis demonstrated more recurrences in re-palatoplasty repaired type III fistulas in patients over 3 years old.
CONCLUSION
A tendency towards using flap repair in large hard palate fistulas, re-palatoplasty in medium hard palate and soft and hard palate junction fistulas, and local flaps or re-palatoplasty in small fistulas at any location was observed. However, it could not be statistically demonstrated whether a specific repair technique was superior in different clinical situations.
Topics: Adolescent; Age Factors; Child; Child, Preschool; Cleft Palate; Female; Follow-Up Studies; Humans; Infant; Male; Oral Fistula; Palate, Hard; Postoperative Complications; Plastic Surgery Procedures; Recurrence; Retrospective Studies; Surgical Flaps
PubMed: 32657098
DOI: No ID Found -
The Journal of Forensic... May 2018To determine differences between open bite and normal vertical overbite regarding distribution, size and clinical appearance of palatal rugae, depth and length of the...
PURPOSE
To determine differences between open bite and normal vertical overbite regarding distribution, size and clinical appearance of palatal rugae, depth and length of the palate, intercanine and intermolar widths and arch perimeter.
METHODS
A cross-sectional study was performed in 264 superior models were studied with a 3D analysis system. A total of 132 individuals with AOB and 132 individuals with normal vertical overbite were evaluated, chosen from public schools with ages between 8 and 16 years. Palatal anthropometric features were evaluated. Qualitative analysis of palatal rugae was performed, exploring the shape, direction, unification and sensitivity of the palate. The Mann Whitney and Chi Square tests were used for statistical analyses.
RESULTS
The average age was 11.37 ± 2.27 years for normal overbite and 11.87 for anterior open bite, with 54.9% of women. No significant differences were found between subjects with AOB and subjects with normal vertical overbite regarding intermolar or intercanine width. The maxillary length and depth and the height and width of palatal rugae were lower in the AOB group. The most common rugae shapes were curved and wavy, predominating in the horizontal direction with a parallel distribution.
CONCLUSION
Qualitative evaluation demonstrated asymmetry in the shape, direction and unification of rugae in both groups. Most arch measurements were greater in individuals with AOB.
Topics: Adolescent; Child; Colombia; Cross-Sectional Studies; Female; Humans; Male; Models, Dental; Open Bite; Overbite; Palate, Hard
PubMed: 29864028
DOI: No ID Found -
Brazilian Oral Research 2022The purpose of this study was to evaluate the clinicodemographic characteristics and treatment protocol as prognostic factors in patients with oral squamous cell...
The purpose of this study was to evaluate the clinicodemographic characteristics and treatment protocol as prognostic factors in patients with oral squamous cell carcinoma (OSCC) of the hard palate, upper gingiva, and alveolar ridge (HPUGAR). This retrospective cohort study collected data of patients treated in two head and neck surgery departments in southern Brazil between 1999 and 2021. Information on clinicodemographic data, habits, site, size, clinical aspect, clinical staging, cervical metastasis, treatment, and survival was collected. Associations between independent variables and outcomes were assessed using Pearson's chi-square test and binary regression. Kaplan-Meier test was employed to compare the survival between the neck approaches. Forty-one patients were included; most were male (61%), with a mean age of 68.8 (± 13.9) years. The consumption of tobacco (p = 0.003) and alcohol (p = 0.02) was significantly higher in male than in female patients. The main clinical features observed in the study sample were lesions larger than 2 cm (48.7%), no cervical (90.2%), or distant metastasis (90.2%). Surgery alone was the main treatment approach (48.8%). The watch-and-wait strategy was adopted in 34 cases (83.0%), while elective neck dissection was applied in five (12.2%). Only two patients with cN0 disease (4.9%) presented with cervical metastasis at follow-up. Eight patients (12.2%) died of the disease. Clinicodemographic variables, habits, surgical margins, and histological subtype were not significantly associated with cervical metastasis or survival. Cervical metastasis (p = 0.004) was associated with poor survival. No difference was detected in survival between different neck approaches (p = 0.28). Cervical metastasis and local recurrence are negative prognostic factors for HPUGAR OSCC.
Topics: Humans; Male; Female; Aged; Carcinoma, Squamous Cell; Palate, Hard; Mouth Neoplasms; Retrospective Studies; Prognosis; Lymphatic Metastasis; Neoplasm Staging; Neoplasm Recurrence, Local; Survival Rate; Squamous Cell Carcinoma of Head and Neck; Alveolar Process; Head and Neck Neoplasms
PubMed: 36507745
DOI: 10.1590/1807-3107bor-2022.vol36.0058