Cohen S R, Chen L, Trotman C A, Burdi A R
Center for Craniofacial Disorders, Scottish Rite Children's Medical Center, Atlanta, GA 30342.
Cleft Palate Craniofac J. 1993 Sep;30(5):441-6. doi: 10.1597/1545-1569_1993_030_0441_spmadf_2.3.co_2.
Surgical correction of clefts of the soft palate leads to varying degrees of normal function although the repair itself is successful. Explanations for this include structural abnormalities of the muscles. Previous studies have focused primarily on gross anatomical features of late fetal and postnatal cleft palate musculature; however, infrequent reference has been made to early prenatal morphologic patterns of soft-palate development, beginning with the embryo. Thus we evaluated the chronology of prenatal myogenesis of the soft palate from its early mesenchymal phase through the appearance of definitive palatal muscles and associated structures in a sample of 22 human fetuses that represented postfertilization weeks 6.5 to 20.5 (18- to 192-mm crown-rump length). Specimens were histologically prepared for descriptive and morphometric light microscopy. Data were collected on the earliest appearance times of identifiable soft palate and associated structures within the mesenchymal field and on their individual stages of myogenesis (e.g., for muscles, from mesenchyme to myoblasts to fascicles). Analyses showed that (1) palatal muscles and related bony structures emerge sequentially as densely staining mesenchymal subfields within the larger mesenchymal soft-palate field during the 6- to 9-week period, with the tensor veli palatini muscle appearing earliest, and the musculus uvulae latest; (2) further morphogenesis of the soft palate and associated structures follows a definite timeline; and (3) by 16 to 17 weeks the postnatal palatal morphology is in place.
尽管软腭裂修复手术本身是成功的，但术后功能恢复程度却各不相同。对此的解释包括肌肉结构异常。以往的研究主要集中在胎儿晚期和出生后腭裂肌肉组织的大体解剖特征上；然而，对于从胚胎期开始的软腭早期产前形态学模式却鲜有提及。因此，我们评估了22例人类胎儿样本中软腭产前肌生成的时间顺序，这些样本代表受精后6.5至20.5周（顶臀长度18至192毫米），涵盖了从早期间充质阶段到确定的腭部肌肉及相关结构出现的整个过程。标本经过组织学处理，用于描述性和形态计量学的光学显微镜观察。收集的数据包括在间充质区域内可识别的软腭及相关结构的最早出现时间，以及它们各自的肌生成阶段（例如，对于肌肉，从间充质到成肌细胞再到肌束）。分析表明：（1）在6至9周期间，腭部肌肉和相关骨骼结构作为较大的间充质软腭区域内密集染色的间充质子区域依次出现，腭帆张肌最早出现，腭垂肌最晚出现；（2）软腭及相关结构的进一步形态发生遵循明确的时间线；（3）到16至17周时，出生后的腭部形态已形成。
