Introduction
Cleft plate represents the second most frequently occurring congenital deformity (after clubfoot deformity). Cleft plate, cleft palate or both affects approximately 1 in 750 births. Clefting is associated with many problems including cosmetic and dental abnormalities, as well as speech, , hearing and facial growth difficulties. The otolaryngologist is uniquely qualified to identify and manage many of these problems, and holds a key role on the cleft palate team.
Anatomy
The palate consists of the hard palate and soft palate, which together form the roof of the mouth and the floor of the nose. The palatine processes of the maxilla and horizontal lamina of the palatine bones form the hard palate. Its blood supply is mainly from the greater palatine artery, which passes through the greater palatine foramen. The nerve supply is via the anterior palatine and nasopalatine nerves. The soft palate is a fibromuscular shelf made up of several muscles attached like a sling to the posterior portion of the hard palate. It closes off the nasopharynx by tensing and elevating, thereby contacting Passavants ridge posteriorly. The soft palate consists of the tensor veli palatini, the levator veli palatini, the musculus uvulae, the palatoglossus, and palatopharyngeus muscles. CN V supplies the tensor veli palatini, while CN IX and CN X innervate the others. The levator veli palatini is the primary elevator of the palate.
Embryology
The primary and secondary palates are delineated according to embryological development. The primary palate or premaxilla is a triangular area of the anterior hard palate extending from anterior to the incisive foramen to a point just lateral to the lateral incisor teeth. It includes that portion of the alveolar ridge containing the four incisor teeth.......
