Lip And Palate

The anatomical studies of Veau laid the foundation for our present understanding of cleft lip and palate (Veau, 1926, 1931, 1935). His embryologic research into the pathogenesis of cleft lip and palate in the human is a classic study (Veau and Politzer, 1936). Veau recognized that unilateral and bilateral cleft conditions showed a characteristic skeletal deformity that was consistently uniform in each cleft type, and he regarded the skeletal deformity as a product of abnormal growth subsequent to the initial embryonic failure of palate formation. It was his opinion that the protrusion of the anterior premaxillary segment seen in the unilateral and bilateral conditions was caused by uninhibited growth of the bony part of the septal stem, consisting of the vomer and premaxillary bones. The premaxillovomeral suture was regarded as having growth potential similar to that of long bone epiphyseal plates. Consideration of numerous details of the anatomical analysis presented in the chapter may render untenable the hypothesis of growth thrust from the bony septal stem. A synthesis of the available material, in keeping with present concepts of growth and development, is proposed to which scrutiny is invited, both to test the facts and to prompt appraisal of treatment principles.