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Is the collateral circulation pattern in the hard palate affected by cleft deformity?
Arvin Shahbazi1,2,3, Andreas A Mueller4,5, Szilvia Mezey6
1Department of Anatomy, Histology and Embryology (Oral Morphology Group), Semmelweis University, Budapest, Hungary. arwin_shahbazi@hotmail.com.
Clinical Oral Investigations
|April 26, 2024
Summary
Collateral vascularization in cleft palates shows distinct patterns. Surgeons should preserve existing arteries in the non-cleft zone during surgical repair for better outcomes.
Area of Science:
- Craniofacial anatomy
- Vascular surgery
- Pediatric surgery
Background:
- Cleft palate repair requires detailed understanding of palatal vascularization.
- Collateral circulation plays a crucial role in tissue viability during reconstructive surgery.
Purpose of the Study:
- To investigate the influence of collateral vascularization on surgical outcomes in cleft palate repair.
- To analyze vascular patterns in normal and cleft palates.
Main Methods:
- Corrosion casting with acrylic resin in adult cadavers with normal palates.
- Barium sulfate injection and layer-by-layer dissection in a fetal specimen with unilateral cleft palate.
- External carotid artery injection and enzymatic tissue dissolution for detailed vascular visualization.
Main Results:
- Normal palates exhibit intricate arterial networks involving infraorbital, nasopalatine, and greater palatine arteries (GPAs).
- Cleft palates show omitted anastomoses in the cleft zone but enlarged GPAs in the non-cleft zone, following anatomical courses.
- Complex vascularization was noted in the retrotuberal region of normal palates.
Conclusions:
- Palatal anatomical subunits display unique anastomosis patterns.
- Arterial patterns in the non-cleft zone of cleft palates resemble normal specimens.
- Surgical techniques should prioritize preserving existing anastomoses in the cleft zone, particularly in the incisive canal, alveolar ridges, and retrotuberal areas.
