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Classic and occult submucous cleft palates: a histopathologic analysis

S Stal1, M J Hicks

  • 1Cleft Palate-Craniofacial Center, Department of Plastic Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston 77030-2399, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|July 31, 1998
PubMed
Summary

Submucous cleft palate involves significant fibrosis and muscle atrophy in the palate's midline. This study reveals disorganized muscle fibers and fibrosis in both classic and occult submucous clefts, suggesting developmental abnormalities.

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Area of Science:

  • Histopathology
  • Oral and Maxillofacial Surgery
  • Developmental Biology

Background:

  • Submucous cleft palate, both classic and occult, presents with poorly understood histologic characteristics.
  • Existing knowledge focuses on clinical and endoscopic findings, lacking detailed microscopic insights into the midline palatal tissue.

Purpose of the Study:

  • To describe the histopathologic features of the midline palatal area in patients with classic and occult submucous clefts.
  • To investigate the role of histologic abnormalities in the pathogenesis of submucous cleft palate.

Main Methods:

  • Histopathologic examination of two biopsies (muscular uvulae and levator muscle bundle) from 28 patients (12 classic, 16 occult submucous clefts).

Main Results:

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  • Significant submucosal fibrosis with dense collagen deposition was observed in both biopsy sites.
  • Myocytes exhibited atrophy or hypoplasia (mean diameter reduction of 53%) and fascicular disorganization.
  • Minor salivary glands also showed increased collagen deposition.

Conclusions:

  • Submucous cleft palate is characterized by significant, well-organized fibrosis and myocyte atrophy/hypoplasia.
  • The observed myocyte fascicular disorganization suggests a failure in epithelial-mesenchymal tissue resorption during palatine shelf closure.
  • These findings point to a chronic, developmental process underlying submucous cleft palate formation.