EMBRYOLOGY OF THE

HEAD AND NECK

PGI Basilio
August 2018
 Head
formation
• rostral or head fold
• anterior portion of the neural tube
expands as the forebrain, midbrain
and hindbrain
• the neuroectoderm in this region will
form the olfactory, orbital and
otic placodes
• the hindbrain forms 8 bulges =
rhombomeres
• the paraxial mesoderm in this region
also segments into somites
• migration of neural crest cells into
this region provides the embryonic
connective tissue (mesenchyme)
required for development of the
craniofacial structures
• these neural crest cells arise from the
midbrain and the first two
rhombomeres as two streams
Branchial arches
• also called pharyngeal arches
• figure 4-11
• fourth week: development of a
frontal prominence forms the
stomatodeum
• below this is the formation of the
first branchial arch
(mandibular arch)

• 6 pairs – U shaped
– core of mesenchymal tissue
formed from neural crest cells that
migrate in to form the arches
– covered externally by ectoderm
and lined internally by endoderm
– each has its own developing
cartilage, nerve, vascular and
muscular components
• these arches separate the
stomatodeum from the developing
heart
 Branchial arches
• separated laterally by branchial grooves/clefts

• medially they are separated by pharyngeal pouches

• first arch (mandibular arch) – maxillary and mandibular
processes
• second arch (hyoid arch) - hyoid bone, part of the temporal bone
(VII nerve)
• cartilage = Reichert’s cartilage
• the mesoderm of this arch will form the muscles of facial expression, the
middle ear muscles

• third arch –tongue (IX nerve)

• fourth arch –tongue, most of the laryngeal cartilages (IX and X
nerves)
• fifth arch – becomes incorporated into the fourth
• sixth arch – most of the laryngeal cartilages (IX and X nerves)
 Pharyngeal Pouches
– four well-defined pairs of pharyngeal pouches develop from
the lateral walls of the pharynx

– first pouch (betwen the 1st and 2nd arches) - external acoustic
meatus, tympanic membrane, and eustachian tube
– second pouch – palatine tonsils
– third pouch - thyroid and parathyroid glands,
– fourth pouch – parathryoid gland
– fifth pouch -becomes incorporated into the fourth
 Development of the Face
• forms from the fusion of 5 face primordia
which develop during week 4 and fuse
during weeks 5 through 8
– primordia = ectodermal swellings or
prominences that are filled with mesodermal
and neural crest cells
• frontonasal prominence
• mandibular prominences (2) – from branchial
arch #1
• maxillary prominences (2) – from branchial arch
#1
Development of
the Face
 Stomatodeum
• primitive
stomatodeum forms a
wide shallow
depression in the face
– limited in its depth
by the
buccopharyngeal
membrane
Development of the Upper Face
• within the fourth week (weeks 5 –
8)
• the frontonasal prominence
develops two sets of placodes
(nasal and lens)
• formation is dominated by the
proliferation and migration of
ectomesenchyme cells
• MAJOR EVENTS
– development of medial and lateral
nasal processes or swellings which
encircle the nasal pits
– fusion of the medial nasal
processes at the midline =
intermaxillary/premaxillary
process or process
• formation of the upper portion of
the face is faster than the lower
portion (finally cease to grow at
puberty)
 Development of the Upper Face
– rapid proliferation of the underlying
mesenchyme around the placodes
results in bulges in the frontal
eminence and produces a horseshoe-
shaped ridge in each olfactory placode
• medial and lateral nasal processes
– in between the medial nasal processes
is where the nose develops = called
the frontonasal prominence
– the medial nasal processes of both
sides + the frontonasal prominence
give rise to the middle portion of the
nose, upper lip, anterior portion of the
maxilla and the primary palate
– the medial nasal processes also fuse
internally and form the
premaxillary segment
– the frontonasal prominence will also
form part of the forehead
 Development of the Upper Face
• day 24: development of the
frontal prominence (covers the
rapidly expanding forebrain)
– beginnings of the mandibular and
maxillary processes from the 1st
branchial arch
– well-defined boundaries of the
stomatodeum results
• day 26: well-formed maxillary
and mandibular processes
• day 27: appearance of the
nasal placode and the
odontogenic epithelium
• day 28: localized thickenings
develop within the frontal
prominence = olfactory
placodes
 Upper lip formation
• during the fourth week
• fusion of the maxillary processes
with each medial nasal process
• this contributes to the lateral sides
of the upper lip – together with the
medial nasal processes which
contribute to the medial aspect of
the upper lip
• the maxillary processes also fuse
with the lateral nasal processes –
results in a nasolacrimal
groove which extends from the
medial corner of the eye to the
nasal cavity
 Development of the Palate
• involves the formation of a
primary palate, a secondary palate
and fusion of their processes
• Primary palate
– forms from an internal swelling of the
intermaxillary/premaxillary process
(fusion of medial nasal processes)
• Secondary palate
– forms from the two lateral palatine
shelves or processes
– develop as internal projections of the
maxillary prominences
 Primary palate
• fusion of the median
nasal processes gives
rise to the median
palatine process –
fuses to form the
primary palate
 Secondary Palate
• the common oronasal cavity is bounded
anteriorly by the primary palate and
occupied by the developing tongue
• only after the development of the
secondary palate can oral and nasal
cavities by distinguished

• three outgrowth appear in the oral cavity

– nasal septum:
• grows downward through the oral cavity
• it encounters the primary and secondary
palates
– two palatine shelves
• closure of the secondary palate is likely
to involve the hardening of the palatine
shelves – mechanism remains unknown
+ the withdrawl of the tongue
Palatine shelves
 Nose
• complex combination of contributions of the
frontal prominence (forms the bridge), the
merged medial nasal prominences (form the
median ridge and tip of nose), the lateral nasal
prominences (form the alae) and the cartilage
nasal capsule (forms the septum and the nasal
conchae)

• the external nasal region develops from the

superficial alar field – gives rise to the alae
 Nose
• Nasal pits and cavities
– separate anteriorly from the stomatodeum by fusion of the medial
nasal, lateral nasal and maxillary prominences – form the nostrils
– separate posteriorly from the stomatodeum by the oronasal
membrane
– the developing nasal cavities are separated from the oral cavity by
the intermaxillary process (forms the floor of the nasal cavity)

• Nasal capsule and nasal septum

– condensation of the mesenchyme within the frontonasal
prominence – forms the precartilagenous nasal capsule
– the capsule develops as two masses around the nasal cavities
– the median mass becomes the progenitor of the nasal septum
– the lateral masses will form the conchae and nasal alar cartilages
• nasal cavity
– early development of the face is
dominated by the proliferation and
migration of tissue involved in the
formation of the primitive nasal cavities
– about 28 days localized thickenings
develop within the primitive ectoderm of
the embryo – olfactory placodes
– rapid proliferation of the underlying
mesenchyme around the placodes bulges
the frontal eminence forward and
produces the nasal pit
– the lateral arm of this pit = lateral nasal
process
– the media arm = medial nasal process
– in between these nasal pits is the
frontonasal process – where the nose
develops
– the two medial processes + the
frontonasal give rise to the medial portion
of the nose and upper lip, the anterior
portion of the maxilla and palate
 Nasal and Paranasal tissues
• nasal cavity lined with a respiratory mucosa like the rest of the respiratory
system
• pseudostratified columnar epithelium with cilia
• interspersed are goblet cells which rest on the basement membrane

• very vascular lamina propria – warms the air

• roof of the nasal cavity is a specialized area that contains the olfactory
epithelium
• on the medial wall are the three nasal conchae

• paranasal sinuses
– frontal, sphenoid, maxillary and ethmoid sinuses
– provide mucus for the nasal cavity
– respiratory mucosa of ciliated pseudostratified columnar epithelium
– but is thinner than the nasal mucosa – also has fewer goblet cells
– no erectile tissue
Development of Sinuses and Nasal
cavity
• paranasal sinuses
– some develop during late fetal life
• frontal and sphenoid not present at birth
• at 2 years the two most anterior ethmoid sinuses grow into
the frontal bone – visible on X-rays by age 7
• two most posterior ethmoid sinuses grow into the sphenoid
bone
• sinuses are important in the size and shape of the face
during infancy and the resonance of the voice
– the rest develop after birth
– form as outgrowths of the wall of the nasal cavity
– become air-filled extensions in the adjacent bones
– the original openings of these outgrowths persist as
the orifices of the adult sinuses
 Maxilla formation
• centers of ossification develop in the mesenchyme of the maxillary processes
of the first branchial arch

• spreads posteriorly below the orbit towards the developing zygoma and
anteriorly toward the future incisor region and superiorly to form the
frontal process

• ossification also spreads into the palatine process to form the hard palate

• at the union between the palatal process and the main body of the
developing maxilla is the medial alveolar plate – together with the
lateral plates – development of the maxillary teeth

• a zygomatic or malar cartilage appears in the developing zygomatic

processes and contributes to the development of the maxilla
Development of the Lower Face
• within the fourth week
• two bulges form inferior to the
stomatodeum
 Mandible formation
• the cartilage of the first branchial arch
associated with the formation of the
mandible = Meckel’s cartilage

• 6 weeks: Meckel’s cartilage forms a rod

surrounded by a fibrocellular capsule

• the two cartilages do not meet at the midline

but are separated by a thin line of cartilage =
symphysis
• on the lateral aspect of this symphysis – a
condensation of mesenchyme forms

• at 7 weeks intramembranous ossification

begins in this mesenchyme and spreads
anteriorly and posteriorly to form the bone
of the mandible
• the bone spreads anteriorly to the midline of
the developing lower jaw – the bones do not
fuse at the midline – mandibular symphysis
forms (from meckel’s cartilage)
– which fuses shortly after birth
• the ramus develops from rapid ossification
posteriorly into the mesenchyme of the first
arch
 Mandible formation
-Meckel’s cartilage does NOT contribute directly to the ossification of
the mandible
-posterior extremity – malleolus of the inner ear
-portion persists as the sphenomandibular ligament
-significant portion is resorbed entirely
-most anterior portion near the midline may contribute to the jaw
through endochondral ossification
-growth of the mandible until birth is influences by the appearance of
three secondary (growth) cartilages
1. condylar – 12th week, developing ramus by endochondral
ossification, a thick layer persists at birth at the condylar head
(mechanism for post-natal growth of the ramus = endochondral)
2. coronoid – 4 months, disappears before birth
3. symphyseal – appears in the connective tissue at the ends of the
Meckel’s cartilage, gone after 1 year after birth
 Development of the Tongue
• begins to develop about 4 weeks
• localized proliferation of the
mesenchyme results in formation of
several swellings in the floor of the oral
cavity
• the oral part (anterior two-thirds)
develops from the fusion of two distal
tongue buds or lateral lingual
swellings and a median tongue
bud (tuberculum impar)

• the pharyngeal part or root of the

tongue (posterior one-third) develops B.As #1,2 and 3
from the copula and the hypobranchial arch
hypobranchial eminence (forms overgrows the 2nd arch
from the 2nd, 3rd and 4th branchial
arches)

• these parts fuse (adult = terminal

sulcus)
• muscles of the tongue arise from
occipital somites which migrate into
the tongue area
 END OF
PRESENTATION