Congenital Palatal Ulcers in Newborn Infants with Cleft Lip and Palate: Diagnosis, Frequency, and Significance

Abstract

Congenital decubital ulcers were found in 94% of newborn infants with unilateral cleft lip and palate in the course of a systematic study of a large cohort study (N = 52). The procedures for diagnosis, documentation, and follow-up are described. The ulceration area at birth varied over a wide range. The ulcerations were usually located in the posterior part of the vomer. Sonographic evidence supports the hypothesis that the ulcerations are caused mechanically by the motor activity of the tongue during the fetal and newborn period. The decubital ulcer disappeared in each case within 5 days following the implementation of a palatal plate.

Aktuelle Behandlungsprinzipien bei Lippen-, Kiefer-und Gaumenspalten aus Sicht des Kieferorthop�den

“…The most frequent location of the ulcers was the posterior part of the vomer, while in patients with broad clefts the lower turbinate was also affected. Earlier reports, attributing the ulceration to the use of presurgical jaw orthopedic appliances, seem to have no validity today [1,88], although it is evident that inappropriate treatment procedures could traumatize the mucosa. The use of a palatal plate seems to facilitate healing, since ulcers disappeared within 5 days of plate insertion.…”

“…Die hfiufigste Stelle, an der sich Ulzerationen befanden, war der posteriore Anteil des Vomers, wS.hrend bei Patienten mit breiten Spalten die untere Nasenmuschel ebenso betroffen war. FNhere Studien, die die Ulzerationen anf die prfichimrgische kieferorthop~idische Behandlung zurfickl~hrten, scheinen heute keine Gtiltigkeit mehr zu haben [1,88], obwohl es offensichtlich ist, dab nicht geeignete Behandlmagsverfahren die Mukosa traumatisieren k6nnen. Das Einsetzen einer Trinkplatte scheint die Abheilung zu erleichtern, da die Ulzerationen innerhalb yon fiinf Tagen nach Einsetzen der Platte verschwanden.…”