Cleft Palate Embryology — MFDS Part 1 MCQ

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ModerateAnatomy (Head & Neck)Cleft Palate EmbryologyMFDS Part 1

A newborn has an isolated midline cleft affecting the hard and soft palate posterior to the incisive foramen, with an intact upper lip and alveolus. This defect most directly results from failure of fusion between which structures?

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Correct answer: C — Right and left lateral palatine shelves

Option C is correct. The secondary palate develops from the paired lateral palatine shelves, which arise from the maxillary processes. These shelves elevate above the tongue and fuse with each other in the midline; failure of this inter-shelf fusion produces a midline cleft posterior to the incisive foramen. The intact lip and alveolus indicate that the primary palate is unaffected. Fusion involving the medial nasal and maxillary processes is principally relevant to formation of the upper lip and primary palate, so failure may cause cleft lip with or without an anterior palatal defect. The mandibular processes form the mandible, while the first and second pharyngeal arches do not fuse to form the secondary palate.

Reference: Hammond NL, Dixon J, Dixon MJ. Periderm: Life-cycle and function during orofacial and epidermal development. Seminars in Cell & Developmental Biology. 2019;91:75–83. https://pubmed.ncbi.nlm.nih.gov/28803895/