MUSCULATURE OF THE SOFT PALATE - CLINICO-ANATOMIC CORRELATIONS AND THERAPEUTIC IMPLICATIONS IN THE TREATMENT OF CLEFT PALATES

Objective: Hypoplasia of the maxilla, often described as a classic seq uela to surgical repair of the cleft palate, has been rare in our expe rience. We believe that our surgical technique, which includes dividin g the nasal mucosa and the abnormal muscular insertions at the posteri or border of the hard palate, is an important factor in preventing thi s sequela. Method: We compared the anatomy of 12 normal palates in cad avers to the anatomy of cleft palates seen at operation and to the ana tomy of one cleft palate in a fetus aged 34 weeks. Results: in cleft p alates, the muscular fibers have an abnormal sagittal orientation, ins erting on the posterior border of the hard palate. Conclusion: The div ision of both the nasal mucosa and these abnormal muscular insertions at the posterior border of the hard palate enables the surgeon to elim inate the abnormal posterior pull of these fibers on the maxilla.