The Oral Cavity

(Oral Cavity (Mouth

Extends from the lips to the Oropharyngeal Isthmus The Oropharyngeal Isthmus: Is the junction of mouth and pharynx. Is bounded:
Above by the Soft Palate And The Palatoglossal Folds Below by the Dorsum Of The Tongue

Subdivided Into Vestibule & Oral Cavity Proper

Vestibule
Slitlike space between the cheeks and the gums Communicates with the exterior through the oral fissure When the jaws are closed, communicates with the oral cavity proper behind the 3rd molar tooth on each side Superiorly and inferiorly limited by the reflection of mucous membrane from lips and cheek onto the gums

Functions
The function of the mouth and its associated structures is to form a receptacle for food, to begin mechanical digestion through chewing (mastication), and to form words in speech. It can also assist the respiratory system in the passage of air.

Vestibule contd
The lateral wall of the vestibule is formed by the cheek The cheek is composed of Buccinator muscle, covered laterally by the skin & medially by the mucous membrane A small papilla on the mucosa opposite the upper 2nd molar tooth marks the opening of the duct of the parotid gland

THE MOUTH CAVITY PROPER

ROOF: Formed by the hard and soft palate. FLOOR: Largely occupied by tongue. The frenulum of the tongue connects the under-surface of the tongue with the floor of the mouth.

The hard palate

incisive papilla transverse palatine folds or rugae palatine raphe Soft palate uvula

Parts of the oral cavity

Hard & Soft palate Tongue Alveolar margins of maxillae & mandible Teeth Gums Cheek

Oral Cavity Proper

It is the cavity within the Alveolar Margins Of The Maxillae And The Mandible Its Roof is formed by the Hard Palate Anteriorly and the Soft Palate Posteriorly Its Floor is formed by The anterior 2/3rd of the tongue lies on the floor & by the Mylohyoid Muscle.

hard soft palate

mylohyoi d

The hard palate

Concave towards the oral side Filled with tongue when at rest The ant 2/3 has a bony skeleton formed by
Palatine Process Of Maxilla Horizontal Plates Of Palatine Bones

Floor of the Mouth

Covered with mucous membrane In the midline, a mucosal fold, the frenulum, connects the tongue to the floor of the mouth On each side of frenulum a small Papilla has the opening of the Duct Of The Submandibular Gland A rounded ridge extending backward & laterally from the papilla is produced by the Sublingual Gland

Nerve Supply
o Sensory
Roof: by Greater Palatine And Nasopalatine Nerves (branches of maxillary nerve) Floor: by lingual nerve (branch of Mandibular Nerve) Cheek: by buccal nerve (branch of Mandibular Nerve)

o Motor
Muscle in the cheek (buccinator) and the lip (orbicularis oris) are supplied by the Branches Of The Facial Nerve

The Tongue
The tongue is the principal organ of the sense of taste, and an important organ of speech; it also assists in the mastication and deglutition of the food (Accessory GIT Organ). Its divided into Anterior 2/3 & Posterior 1/3 by Sulcus Terminalis (V-shape-depression) Its Ant. 2/3 form most of floor of the mouth. Its Inferior surface is connected to the midline of the floor of the mouth by a fold of mucous membrane called Frenulum of the tongue. Its muscles (Extrinsic) are connected upward to the Styloid process and soft palate and downwards to mandible and Hyoid bones.

Tongue
Sulcus Terminalis tip points backward and marks Foramen Cecum (Remnant of thyroglossal duct). Connection with the epiglottis creates three folds (glossoepiglottic). Its Ant. 2/3 Upper surface is covered by Papillae which are: Filliform, Fungiform & Valate Papillae. No papillae in the posterior surface Inferiorly: Lingual tonsil are present under the post. 1/3 and two deep lingual veins run in the lateral margins. Lingual Frenulum attaches it to midline of floor of the mouth.

Tongue
Mass of Striated Muscles covered with the mucous membrane Divided into right and left halves by a median septum Three parts: Oral (anterior ) Pharyngeal (posterior ) Root (base) Two surfaces: Dorsal Ventral

Functions
The tongue is the most important articulator for Speech Production. During speech, the tongue can make amazing range of movements The primary function of the tongue is to Provide A Mechanism For Taste. Taste buds are located on different areas of the tongue, but are generally found around the edges. They are sensitive to four main tastes: Bitter, Sour, Salty & Sweet

 The tongue is needed for sucking, chewing, swallowing, eating, drinking, kissing, sweeping the mouth for food debris and other particles and for making funny faces (poking the tongue out, waggling it) Trumpeters And Horn & Flute Players Have Very Well Developed Tongue Muscles, and are able to perform rapid, controlled movements or articulations

Dorsal Surface
Divided into anterior two third and posterior one third by a V-shaped sulcus terminalis. The apex of the sulcus faces backward and is marked by a pit called the foramen cecum Foramen cecum, an embryological remnant, marks the site of the upper end of the thyroglossal duct

 Anterior two third: mucosa is rough, shows three types of papillae: Filliform Fungiform Vallate Posterior one third: No papillae but shows nodular surface because of underlying lymphatic nodules, the lingual tonsils

Ventral Surface
Smooth (no papillae) In the midline anteriorly, a mucosal fold, frenulum connects the tongue with the floor of the mouth Lateral to frenulum, deep lingual vein can be seen through the mucosa Lateral to lingual vein, a fold of mucosa forms the plica fimbriata

Tongue
Sulcus Terminalis tip points backward and marks Foramen Cecum (Remnant of thyroglossal duct). Connection with the epiglottis creates three folds (glossoepiglottic). Its Ant. 2/3 Upper surface is covered by Papillae which are: Filliform, Fungiform & Valate Papillae. No papillae in the posterior surface Inferiorly: Lingual tonsil are present under the post. 1/3 and two deep lingual veins run in the lateral margins. Lingual Frenulum attaches it to midline of floor of the mouth.

Tongue
The circumvallate papill are of large size, and vary from eight to twelve in number. They are situated on the dorsum of the tongue immediately in front of the foramen cecum and sulcus terminalis and meet in the middle line, like the limbs of the letter V inverted. The fungiform papill more numerous are found chiefly at the sides and apex, but are scattered irregularly and sparingly over the dorsum. They are easily recognized, among the other papill, by their large size, rounded eminences, and deep red color.

Tongue
The filiform papil cover the anterior twothirds of the dorsum. They are very minute, filiform in shape. Projecting from their apices are numerous filamentous processes, or secondary papill these are of a whitish tint, owing to the thickness and density of the epithelium of which they are composed, which has here undergone a peculiar modification, the cells having become cornified and elongated into dense, creating brush-like processes (CATS).

Muscles of the Tongue

The tongue is divided into lateral halves by a median fibrous septum which extends throughout its entire length and is fixed below to the hyoid bone. In either half there are two sets of muscles, extrinsic and intrinsic; the former have their origins outside the tongue, the latter are contained entirely within it.

Extrinsic Muscles
They are: Genioglossus. Hyoglossus. Styloglossus. Palatoglossus

Muscles of the Tongue

The intrinsic muscles: are: Longitudinal, Transverse and Vertical fibers. Their origin and insertion is within the tongue. The function to alter the shape of the tongue.

Muscles of the Tongue

Nerves.The muscles of the tongue described above are supplied by the hypoglossal nerve. Actions.The movements of the tongue, although numerous and complicated, may be understood by carefully considering the direction of the fibers of its muscles. Protrusion: Action of Genioglossus from both sides. Retraction: Action of Styloglossus and hyoglossus from both sides. Depression: Action of Hyoglossus on both sides. Retraction and Elevation of Post. 1/3: Action of Styloglossus and Palatoglossus. The Hyoglossi depress the tongue, and draw down its sides. The Styloglossi draw the tongue upward and backward.

Muscles of the Tongue

The Genioglossus is a flat triangular muscle close to and parallel with the median plane. It arises by a short tendon from the superior mental spine on the inner surface of the symphysis menti It is insertion into the tongue and hyoid bone. Hyoglossus, thin and quadrilateral, arises from the side of the body and from the whole length of the greater cornu of the hyoid bone, and passes almost vertically upward to enter the side of the tongue.

Vessels and Nerves of Tongue

The main arteries of the tongue is the lingual branch of the external carotid, but the maxillary and ascending pharyngeal also give branches to it. The veins open into the internal jugular. The lymphatics of the tongue: Tip of the tongue: Sumnental. Lateral parts: Submandibular and deep cervical LN. Posterior 1/3: Deep Cervical LN. The sensory nerves of the tongue are: (1) General Sensation: The lingual branch of the mandibular, which is distributed to the papill at the Tip and sides of the tongue (2) Taste: The chorda tympani branch of the facial, is generally regarded as the nerve of taste for the anterior two-thirds. (3) The lingual branch of the glossopharyngeal, which is distributed to the mucous membrane at the base and sides of the tongue, and to the papill vallat, and which supplies both gustatory filaments and fibers of general sensation to this region.

Muscles
The tongue is composed of two types of muscles: Intrinsic Extrinsic

Intrinsic Muscles
Confined to tongue No bony attachment Consist of: Longitudinal fibers Transverse fibers Vertical fibers Function: Alter the shape of the tongue

Connect the tongue to the surrounding structures: the soft palate and the bones (mandible, hyoid bone, styloid process) Include: Palatoglossus Genioglossus Hyoglossus Styloglossus Function: Help in movements of the tongue

Extrinsic Muscles

Movements
Protrusion:
Genioglossus on both sides acting together

Retraction:
Styloglossus and hyoglossus on both sides acting together

Depression:
Hyoglossus and genioglossus on both sides acting together

Elevation:
Styloglossus and palatoglossus on both sides acting together

Anterior :

Sensory Nerve Supply

General sensations: Lingual nerve Special sensations : chorda tympani

Posterior :
General & special sensations: glossopharyngeal nerve

Base:
General & special sensations: internal laryngeal nerve

Motor Nerve Supply

Intrinsic muscles: Hypoglossal nerve Extrinsic muscles: All supplied by the hypoglossal nerve, except the palatoglossus The palatoglossus supplied by the pharyngeal plexus

Blood Supply
Arteries: Lingual artery Tonsillar branch of facial artery Ascending pharyngeal artery Veins: Lingual vein, ultimately drains into the internal jugular vein
Lingual artery & vein Dorsal lingual artery & vein

Hypoglossal nerve

Deep lingual vein

Lymphatic Drainage
Tip:
Submental Nodes bilaterally & then Deep Cervical Nodes

Anterior two third:

Submandibular unilaterally & then Deep Cervical Nodes

Posterior third:
Deep Cervical Nodes (jugulodigastric mainly)

Clinical Notes
Lacerations of the tongue Tongue-Tie (ankyloglossia) (due to
large frenulum)

Lesion of the hypoglossal nerve

The protruded tongue deviates Toward The Side Of The Lesion Tongue Is Atrophied & Wrinkled

If there is goodness in your heart, it will come to your tongue.

Palate
The Palate forms the roof of the mouth and floor of Nasal Cavity. It is divided into twp parts; The hard palate in front, (Incisive foramen) the soft palate behind. The Hard Palate is formed by the Palatine Process of Maxilla and Horizontal plate of Palatine bone. The Palate is bounded in front and at the sides by the alveolar arches and gums; behind, it is continuous with the soft palate. It is covered by mucous membrane of the mouth (stratified squamous epithelium). Along the middle line is Incisive foramen that divides the two parts of hard palate. The Soft Palate is a movable fold, attached to the posterior part of Hard Palate. It ends with a Muscular conical projection; Uvula.

Hard Palate
Posteriorly, continuous with soft palate Its undersurface covered by mucoperiosteum Shows transverse ridges in the anterior parts

Features of the hard palate

Incisive Fossa behind the central incisors. Structures passing from nasal to oral side Nasopalatine Nerves They enter the incisive canals

Features of the hard palate

The Greater Palatine Foramen medial to 3rd Molar for the passage of Greater palatine vessels and nerves which emerge & run forwards to supply the molars, premolars, canines & the palatine mucosa

The hard palate

The lesser palatine foramen through which the following structures pass
Lesser palatine vessels and nerves to supply the soft palate

The hard palate

Mucosa. Firmly adherent to the bone. Lingual Gingiva is continuous with the mucosa An injection of local anaesthetic into gingiva also anaesthetises the palate Deep to mucosa are mucous secreting palatine glands, hence the pitted appearance

The hard palate

Posterior to maxillary incisor teeth is incisive papilla, an elevation of mucosa anterior to underlying incisive foramen Several transverse folds radiate from the papilla, the transverse palatine folds or rugae Central white ridge, the palatine raphe,marks the site of embryonic fusion of bones.

The hard palate

incisive papilla transverse palatine folds or rugae palatine raphe Soft palate uvula

The soft palate

It is the movable posterior third of palate It hangs from the post border of hard palate The expanded tendon of tensor veli palatini muscle forms a strong aponeurosis, the palatine aponeurosis which is attached to the post border of hard palate.

The soft palate

The soft palate extends posteriorly as a free margin The central part hangs as a conical process called uvula The strength of the soft palate comes from palatine aponeurosis which is thick anteriorly & thin posteriorly

Soft Palate
Attached To The Posterior border of the hard palate Covered on its upper and lower surfaces by mucous membrane Composed of: Muscle fibers An aponeurosis Lymphoid tissue Glands Blood vessels Nerves

Palatine Aponeurosis
Fibrous Sheath Attached To Posterior border of hard palate Is expanded tendon of Tensor Velli Palatini Splits to enclose musculus uvulae Gives origin & insertion to Palatine Muscles

 Tensor Veli Palatini

Muscles

Origin: spine of sphenoid; auditory tube Insertion: forms palatine aponeurosis Action: Tenses soft palate

Levator veli palatini

Origin: petrous temporal bone, auditory tube, palatine aponeurosis Insertion: palatine aponeurosis Action: Raises soft palate

Musculus uvulae
Origin: posterior border of hard palate Insertion: mucosa of uvula Action: Elevates uvula

Muscles
Palatoglossus
Origin: Palatine Aponeurosis Insertion: Side Of Tongue Action: Pulls Root Of Tongue Upward, Narrowing Oropharyngeal Isthmus

Palatopharyngeus
Origin: Palatine Aponeurosis Insertion: Posterior Border Of Thyroid Cartilage Action: Elevates Wall Of The Pharynx

Motor Nerve Supply

All The Muscles, Except Tensor Veli Palatini, are supplied by the: Pharyngeal plexus Tensor veli palatini supplied by the: Nerve To Medial Pterygoid, A Branch Of The Mandibular Division of the trigeminal nerve

Soft Palate Sensory Nerve Supply

Mostly by the maxillary nerve through its branches:
Greater Palatine Nerve Lesser Palatine Nerve Nasopalatine Nerve

Glossopharyngeal nerve supplies the region of the soft palate

Blood Supply
Branches of the maxillary artery Greater palatine Lesser palatine Sphenopalatine Ascending Palatine, Branch Of The Facial Artery Ascending Pharyngeal, Branch Of The External Carotid Artery

Clinical Notes
Cleft palate: Unilateral Bilateral Median Paralysis of the soft palate The pharyngeal isthmus can not be closed during swallowing and speech

Pharyngeal isthmus

Muscles of the soft palate

Palatine tonsils inflamed

Blood supply of the palate

Greater palatine artery a branch of descending palatine artery. It also gives off Lesser palatine artery Ascending palatine artery from facial artery

Sensory nerves of the palate

These are branches of maxillary nerve through pterygopalatine ganglion Nasopalatine nerve. Greater palatine nerve. Lesser palatine nerve.

Tongue
The circumvallate papill are of large size, and vary from eight to twelve in number. They are situated on the dorsum of the tongue immediately in front of the foramen cecum and sulcus terminalis and meet in the middle line, like the limbs of the letter V inverted. The fungiform papill more numerous are found chiefly at the sides and apex, but are scattered irregularly and sparingly over the dorsum. They are easily recognized, among the other papill, by their large size, rounded eminences, and deep red color.

Tongue
The filiform papil cover the anterior twothirds of the dorsum. They are very minute, filiform in shape. Projecting from their apices are numerous filamentous processes, or secondary papill these are of a whitish tint, owing to the thickness and density of the epithelium of which they are composed, which has here undergone a peculiar modification, the cells having become cornified and elongated into dense, creating brush-like processes (CATS).

Muscles of the Tongue

The tongue is divided into lateral halves by a median fibrous septum which extends throughout its entire length and is fixed below to the hyoid bone. In either half there are two sets of muscles, extrinsic and intrinsic; the former have their origins outside the tongue, the latter are contained entirely within it.

Extrinsic Muscles
They are: Genioglossus. Hyoglossus. Styloglossus. Palatoglossus

Muscles of the Tongue

The intrinsic muscles: are: Longitudinal, Transverse and Vertical fibers. Their origin and insertion is within the tongue. The function to alter the shape of the tongue.

Muscles of the Tongue

Nerves.The muscles of the tongue described above are supplied by the hypoglossal nerve. Actions.The movements of the tongue, although numerous and complicated, may be understood by carefully considering the direction of the fibers of its muscles. Protrusion: Action of Genioglossus from both sides. Retraction: Action of Styloglossus and hyoglossus from both sides. Depression: Action of Hyoglossus on both sides. Retraction and Elevation of Post. 1/3: Action of Styloglossus and Palatoglossus. The Hyoglossi depress the tongue, and draw down its sides. The Styloglossi draw the tongue upward and backward.

Muscles of the Tongue

The Genioglossus is a flat triangular muscle close to and parallel with the median plane. It arises by a short tendon from the superior mental spine on the inner surface of the symphysis menti It is insertion into the tongue and hyoid bone. Hyoglossus, thin and quadrilateral, arises from the side of the body and from the whole length of the greater cornu of the hyoid bone, and passes almost vertically upward to enter the side of the tongue.

Vessels and Nerves of Tongue

The main arteries of the tongue is the lingual branch of the external carotid, but the maxillary and ascending pharyngeal also give branches to it. The veins open into the internal jugular. The lymphatics of the tongue: Tip of the tongue: Sumnental. Lateral parts: Submandibular and deep cervical LN. Posterior 1/3: Deep Cervical LN. The sensory nerves of the tongue are: (1) General Sensation: The lingual branch of the mandibular, which is distributed to the papill at the Tip and sides of the tongue (2) Taste: The chorda tympani branch of the facial, is generally regarded as the nerve of taste for the anterior two-thirds. (3) The lingual branch of the glossopharyngeal, which is distributed to the mucous membrane at the base and sides of the tongue, and to the papill vallat, and which supplies both gustatory filaments and fibers of general sensation to this region.

Palate Structure
It consists of: Mucous membrane Enclosing Palatine Aponeurosis muscle Muscles vessels, nerves, adenoid tissue, and mucous glands. Palatine Aponeurosis: Fibrous sheat starts at posterior part of hard palate formed by joint tendon of Tensor veli palatini from both sides. Muscles: Tensor Veli Palatini Levator Veli Palatinin. Musculus uvula. Arching lateral- and downward from the base of the uvula are two curved folds of mucous membrane, containing muscular fibers, called the arches or pillars

Muscles of soft palate Muscle Action Nerve Vagus nerve via pharyngeal plexus

levator veli palatinideglutition

tensor veli palatini Deglutition mandibular nerve Palatine Tenses the Aponeurosis Palate palatoglossus respiration Vagus nerve via pharyngeal plexus Vagus nerve via pharyngeal plexus

palatopharyngeus respiration

musculus uvulae moves uvula Vagus nerve via pharyngeal plexus

Muscles of the Palate

The muscles of the palate are: Levator veli palatini. Tensor veli palatini. Pharyngopalatinus.Musculus uvul. The Levator veli palatini is a thick, rounded muscle situated lateral to the choan. It arises from the under surface of the apex of the petrous part of the temporal bone and from the medial lamina of the cartilage of the auditory tube. Its fibers extending obliquely downward and medially to the middle line, where they blend with those of the opposite side.

Muscles of the Palate

The Tensor veli palatini (Tensor palati) is a broad, thin, ribbon-like muscle placed lateral to the Levator veli palatini. It arises by a flat lamella from the scaphoid fossa at the base of the medial pterygoid plate, from the spina angularis of the sphenoid and from the lateral wall of the cartilage of the auditory tube. Descending vertically between the medial pterygoid plate and the Pterygoideus internus it ends in a tendon which is inserted into the palatine aponeurosis. The Musculus uvul arises from the palatine aponeurosis; it descends to be inserted into the uvula.

Muscles of the Palate

The Palatoglossus is a small fleshy fasciculus, narrower in the middle than at either end. It arises from the anterior surface of the soft palate, where it is continuous with the muscle of the opposite side, and passing downward, forward, and lateralward in front of the palatine tonsil It is inserted into the side of the tongue

Muscles of the Palate

The Palatopharyngeus is a long, fleshy fasciculus narrower in the middle than at either end, forming, with the mucous membrane covering its surface, the pharyngopalatine arch. It is separated from the Glossopalatinus by an angular interval, in which the palatine tonsil is lodged. It arises from the soft palate, where it is divided into two fasciculi by the Levator veli palatini and Musculus uvul. Pharyngopalatinus joins the Stylopharyngeus, and is inserted with that muscle into the posterior border of the thyroid cartilage.

Muscles of Soft Palate levator veli palatini. tensor veli palatini. uvulae. palatopharyngeus.

Vessels and Nerves

The arteries supplying the palate are: 1. The greater palatine branch of the maxillary and the Ascending palatine branch of the Facial. 2. Ascending Pharyngeal artery. The veins end chiefly in the pterygoid and tonsillar plexuses. The lymphatic vessels pass to the deep cervical glands. Nerve Supply: The Greater and Lesser palatine and nasopalatine nerves (maxillary nerve) and from the glossopharyngeal.

Movements of Soft Palate & Swallowing

The Stylogossus pushes the food bolus upward and backward. The Palatoglossus pushes the bolus into pharynx. The gap between the nasal cavity & the mouth is closed by Raising the soft Palate. Soft Palate is raised by action of Levator Veli Palatini on both sides. The Palatopharyngeus on both sides pulls the Pharyngeal arches Medially. Also the Superior constrictor muscle moves the posterior pharyngeal wall forward. All of these movements results in closure of the communication between the nose & mouth.

Cleft palate
Cleft palate is a condition in which the two plates of the skull that form the hard palate (roof of the mouth) are not completely joined. The soft palate is in these cases cleft as well. In most cases, cleft lip is also present. Cleft palate occurs in about one in 700 live births worldwide. Palate cleft can occur as complete (soft and hard palate, possibly including a gap in the jaw) or incomplete (a 'hole' in the roof of the mouth, usually as a cleft soft palate). When cleft palate occurs, the uvula is usually split. It occurs due to the failure of fusion of the lateral palatine processes, the nasal septum, and/or the median palatine processes (formation of the secondary palate). The hole in the roof of the mouth caused by a cleft connects the mouth directly to the nasal cavity.

Development of Palate
During the first six to eight weeks of pregnancy, the shape of the embryo's head is formed. Five primitive tissue grow:
a) one from the top of the head down towards the future upper lip; (Frontonasal Prominence) b) two from the cheeks, which meet the first lobe to form the upper lip; (Maxillar Prominence) c) and just below, two additional lobes grow from each side, which form the chin and lower lip; (Mandibular Prominence)

If these tissues fail to meet, a gap appears where the tissues should have joined (fused). This may happen in any single joining site, or simultaneously in several or all of them, resulting in birth defect from a small lip or palate fissure up to a completely malformed face.

Cleft Palate
What are the complications associated with cleft lip and cleft palate? Beyond the cosmetic abnormality, there are other possible complications that may be associated with cleft lip and cleft palate, including the following: Feeding Difficulties Feeding difficulties occur more with cleft palate abnormalities. The infant may be unable to suck properly because the roof of the mouth is not formed completely. Ear Infections And Hearing Loss Ear infections are often due to a dysfunction of the tube that connects the middle ear and the throat. Recurrent infections can then lead to hearing loss. Speech And Language Delay Due to the opening of the roof of the mouth and the lip, muscle function may be decreased, which can lead to a delay in speech or abnormal speech. Referral to a speech therapist should be discussed with your child's physician. Dental Problems As a result of the abnormalities, teeth may not erupt normally and orthodontic treatment is usually required.

Cleft Lip/Palate Causes

Genetic in nature. A specific variation in a gene that can have abnormalities causing the Van der Woude Syndrome increases threefold the occurrence of these deformities has been identified by Zucchero et al in 2004. Environmental influences may also cause, or interact with genetics to produce, orofacial clefting. Some environmental factors that have been studied include: seasonal causes (such as pesticide exposure); maternal diet and vitamin intake; retinoids- which are members of the vitamin A family Anticonvulsant drugs; alcohol; cigarette use; nitrate compounds; organic solvents; parental exposure to lead; and illegal drugs (cocaine, crack cocaine, heroin, etc). If a person is born with a cleft, the chances of that person having a child with a cleft, given no other obvious factor, rises to 1 in 14. In some cases, cleft palate is caused by syndromes which also cause other problems. Stickler's Syndrome can cause cleft lip and palate, joint pain, and myopia. Loeys-Dietz syndrome can cause cleft palate or bifid uvula, hypertelorism, and aortic aneurysm. Cleft lip/palate may be present in many different chromosome disorders including Patau Syndrome (trisomy 13). Many clefts run in families, even though there does not seem to be any identifiable syndrome present.