Craniofacial Development and Growth (Craniofacial by Geoffrey H. Sperber

By Geoffrey H. Sperber

Fresh advances in genetics, molecular biology, diagnostic imaging and surgical recommendations require a considerable figuring out of prenatal improvement morphogenesis. The scientific importance of the traditional mechaniisms of embyogenesis, devlopmental mess ups and consequent craniofacial anomalies is of accelerating situation to plastic and orofacial surgeons, otolarygologists, orthodontists, neonatal pediatricians and speech pathologists. Clinicians facing malformations wanting comprehension of the exponential growth of knowledge on molecular genomics, dysgenesis, teratology and the etiology of the syndromes and anomalies are served by means of this book's succinct contents. whereas delivering clinicians with a simple history for treating craniofacial anomalies, this article will additionally attract eratologists, embryologists and anatomists.

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The greatest migratory movements of the eyes occur from the 5th to 9th weeks post conception; thereafter, they stabilize to the postnatal angulation of the optic axes (at 71° to 68°). Early in fetal life (8 weeks), folds of surface ectoderm grow over the eyes to form the eyelids (see Fig. 3–10, c and d). These remain fused until the 7th month post conception, when invading muscle allows their opening. The Ears The internal ear first manifests as a hindbrain induction of surface ectodermal cells elongating into a thickened otic placode.

Closure is initiated at the boundary between the future hindbrain and the spinal cord (site 1) and at three distinct sites in the cranial region (sites 2, 3, and 4). A fifth closure site, involving a process of canalization, occurs in the caudal region (site 5). The directions of closure are indicated by the arrows. Failure of closure results in neural tube defects, as shown in the right hand panels of Fig. 2–20. The top row depicts anencephaly and craniorachischisis. Encephaloceles (middle row) Figure 2–20 Schematic depiction of neural tube defects, sites of sequential neural-tube closure points (1 to 5) and congenital anomalies consequent to failure of closure.

Leckie) 45 46 Craniofacial Development A B C D E F Figure 3–22 Defects of orofacial development: (a) unilateral cleft lip; (b) bilateral cleft lip; (c) oblique facial cleft and cleft lip; (d) median cleft lip and nasal defect; (e) median mandibular cleft; (f) unilateral macrostomia. Figure 3–23 Bilateral cleft lip and palate, with consequent projection of the median globular process, in a newborn infant. Absence of the head (acephaly) is the most extreme defect. Postcranial structures can continue developing in utero; however, the condition is lethal upon birth.

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