Submitted to: Plastic and Reconstructive Surgery
Publication Type: Peer reviewed journal
Publication Acceptance Date: 8/24/2005
Publication Date: 8/1/2006
Citation: Weinzweig, J., Panter, K.E., Seki, J., Pantaloni, M., Spangenberger, A., Harper, J.S. 2006. The Fetal Cleft Palate: IV. Midfacial Growth and Bony Palatal Development following In Utero and Neonatal Repair of the Congenital Caprine Model. Plastic and Reconstructive Surgery. Vol. 18 No. 1 pp. 81-93. Interpretive Summary: Using a Spanish goat model developed to investigate the mechanism of action of lupine-induced “crooked calf disease” in cattle grazing on western ranges, new information and treatments have been investigated as to the intervention of cleft palate in children. An in utero surgical technique was developed in the first and second experiments of a series in which the fetal cleft palate was repaired during a privileged period of fetal scarless healing. Using this procedure, new information and a better understanding of two important clinical issues in the treatment and management of cleft palate are better understood: midfacial growth and development and fistula formation after conventional surgical repair. This research not only provides new information on the etiology of cleft palate in livestock but this goat model is an important tool in the study of cleft palate and improved management of the cleft palate patient.
Technical Abstract: A Spanish goat model was developed to ascertain the mechanism of action of lupine-induced “crooked calf disease”. This goat model is now being used to study new treatments and improved intervention in the treatment of cleft palate in children. We previously demonstrated that in utero palatoplasty results in scarless healing of the mucoperiosteum and velum, with development of a functional bilaminar soft palate with distinct oral and nasal mucosal layers capable of velopharyngeal closure. This paper is the 4th in a series of studies to compare in utero surgical methods with conventional methods of cleft palate repair. This specific study demonstrated a clear benefit to in utero cleft palate repair and the development of a functional palate in the absence of palatal scarring. Such an advantage could potentially translate to a decreased incidence of speech impairment in human cleft patients following in utero cleft palate repair. These research results provide important information on two critical components in the management of the cleft palate patient: midfacial growth and fistula formation.