How does cleft palate develop?

  Cleft palate is a relatively common oral and maxillofacial malformation. It can occur alone or in conjunction with cleft lip. Cleft palate is not only a soft tissue deformity, but more predominantly a bone tissue deformity. Patients with cleft palate have more severe physical dysfunction such as sucking, eating and speech than cleft lip. The collar bone is often collapsed in the middle of the face due to dysplasia; in severe cases, the face is disc-shaped and the bite is misshapen (often antimandibular or open jaw). All these seriously affect the patient’s chewing function and facial appearance. It adversely affects the patient’s life, study and work; it also easily causes psychological disorders. As with cleft lip, the principle of treatment for cleft palate should be a comprehensive sequence of treatment, and its requirements are higher than those of cleft lip.  Cleft palate is a congenital developmental malformation, which is formed during embryonic development due to the interference of certain factors that affect the normal development of the palate. The normal development of the palate occurs in the seventh week of embryonic development when the bulbous process and the maxillary process develop outside the mouth to form the upper lip of the nose, and also develop inside the mouth. The superior collarette grows vertically in the mouth, forming a palatal protrusion on each side, called the lateral palatal protrusion. After the eighth week of embryonic development, the lateral palatine processes on both sides change from vertical to horizontal growth, first fusing with the anterior maxilla in the midline to form the complete alveolar ridge. Later, it fuses with the nasal septum above the midline to form a complete hard palate, and the oral cavity is completely separated from the nasal cavity. At the 12th week of embryonic life, the lateral palatine processes on both sides fuse in the midline to form a complete soft palate, and the oropharyngeal cavity is completely separated from the nasopharyngeal cavity.  Therefore, the normal development and mutual fusion of the anterior and lateral palatine processes is obstructed by some factors during the development of the embryo at 7-12 weeks, and if on one or both sides, some or all of them do not fuse with the contralateral palatine process, the anterior skull and the nasal septum above, cleft alveolus and palate of corresponding degree on one or both sides can occur. In the 12th week, if some or all of the palatine processes that make up the soft palate and the palatal lobe (uvula) do not fuse, a corresponding degree of cleft palate or cleft uvula can occur. Since the fusion of the palatine process is progressive from anterior to posterior, embryonic development can be affected at different times and the palate can be cleft in different degrees from posterior to anterior.  The causes of cleft palate are as multifaceted as those of cleft lip, and are summarized in two major aspects: genetic and environmental factors, namely genetic factors and various factors affecting embryonic development.