Early in embryonic development, during the 3rd week post-fertilization, the embryo is a flat, disc-shaped organism made up of three layers of pluripotent cells called germ layers, which give rise to all the organs and tissues in the body: an inner layer, called endoderm, a central layer, called mesoderm, and an outer layer, called ectoderm.

1. Development of Face, Nose &
Palate
Dr. AHSAN ALI SIDDIQUI

2. Embryo at 4-5 weeks (Lateral view)

3. Introduction
• Face is derived from the
following structures that lie
around the stomatodaeum
(4th week):
1. Frontonasal process
2. 1st Pharyngeal
(mandibular) arch of
each side:
(a) Maxillary process
(b) Mandibular process

4. Formation of mandibular & maxillary
processes (4th week)
• The single frontonasal prominence ventral to the forebrain.
• The paired maxillary prominences develop from the cranial part of first
branchial arch.
• The paired mandibular prominences develop from the caudal part of first
branchial arch.

5. Five facial primordia
appear as
prominences around
the stomodeum:
• The single frontonasal
prominence
• The paired maxillary
prominences
• The paired mandibular
prominences
FNP

6. Stomatodeum
1 Frontonasal prominence
2 Maxillary prominences
2 Mandibular prominences

7. Further development of face
• Formation of nasal placodes and lens placodes (4th week).
• Nasal placodes sinks below to form nasal pits (5th week).
• Elevations of the nasal pits form the medial and lateral nasal
processes.
• Nasal placodes are primordia of the nose and nasal cavities.

8. Formation of lower lip

9. Formation of upper lip

10. Formation of Nose & Cheeks

11. Formation of External Ear (6th week)

12. Formation of Eyes (7th-8th week)

13. Development of Nasal Cavities

14. Formation of Nasal Septum

15. Development of Paranasal Sinuses
• They develop as
diverticulae of the walls of
the nasal cavity.
• Maxillary sinuses and few
anterior & posterior
ethmoidal air cells develop
in fetal life.
• Frontal and sphenoidal
sinuses develop after birth. From a 3 months old fetus, showing
ethmoid & maxillary sinuses

16.  Frontonasal prominence
forms the:
• Forehead and the bridge
of the nose
• Frontal and nasal bones
 Maxillary prominences form the:
• Upper cheek regions and most of the upper lip
• Maxilla, zygomatic bone & secondary palate
Derivatives of Facial Components

17. Mandibular
prominences fuse and
form the:
• Chin, lower lip, and
lower cheek regions
• Mandible
The lateral nasal prominences form the alae of
the nose
The medial nasal prominences fuse and form the
intermaxillary segment

18. Development of Palate
(Palatogenesis)

19. The medial nasal swellings
enlarge, grow medially and
merge with each other in
the midline to form the
intermaxillary segment.
Human embryo: 7 weeks

20. Intermaxillary Segment
Gives rise to the:
• Philtrum of lip
• Premaxillary part of
the maxilla, that
bears the upper 4
incisors and the
associated gums.
• Primary palate
(region of hard palate
just posterior to the
upper incisors).

21. The palate develops from two primordia:
• The Primary palate
• The Secondary palate
• Begins at the end of the 5th week.
• Gets completed by the end of the 12th week.
• The most critical period for the development of
palate is from the end of 6th week to the
beginning of 9th week.
Palatogenesis

22. The Primary Palate
• Begins to develop:
 Early in the 6th week.
 From the deep part
of the intermaxillary
segment, as median
palatine process.
• Lies behind the
premaxillary part of the
maxilla.
• Fuses with the
developing secondary
palate.

23. The primary palate represents only a
small part lying anterior to the incisive
fossa, of the adult hard palate
Hard palate
Primary
palate
Soft palate
Secondary
palate

24. The Secondary Palate
• Is the primordia of hard
and soft palate
posterior to the incisive
fossa.
• Begins to develop:
 Early in the 6th week.
 From the internal
aspect of the
maxillary processes,
as lateral palatine
process.

25. • In the beginning, the
lateral palatine
processes project
inferomedially on each
side of the tongue.
• With the development
of the jaws, the tongue
moves inferiorly.
• During 7th & 8th weeks,
the lateral palatine
processes elongate
and ascend to a
horizontal position
above the tongue.
Tongue

26. • Gradually the lateral
palatine processes:
 Grow medially and
fuse in the median
plane.
 Also fuse with the:
• Posterior part of
the primary palate
&
• The nasal septum

27. • Fusion with the nasal
septum begins
anteriorly during 9th
week, extends
posteriorly and is
completed by 12th
week.
Bone develops in the
anterior part to form the
hard palate. The
posterior part develops
as muscular soft palate

28. Embryological subdivisions of the palate

29. Anomalies related to Face,
Nose & Palate

30. Facial clefts
Failure of the embryonic facial
prominences to fuse properly
• May be unilateral or bilateral
• May involve:
 Lips only: Cleft lip
 Palate only: Cleft palate
 Lip & palate: Cleft lip & palate
 Region of nasolacrimal
groove: Facial clefts
Lead to
difficulty in
breathing
feeding
sucking
swallowing
&
speech

31. • Median cleft lip: results from
failure of the medial nasal
prominences to merge and form
the intermaxillary segments .
• Unilateral cleft lip: result from
failure of the maxillary
prominence to merge with the
medial nasal prominence on the
affected side.
• Bilateral cleft lip: results due to
failure of maxillary prominences
to meet and unite with the medial
nasal prominences on both sides.
Median Cleft lip
Unilateral cleft lip
Bilateral cleft lip

32. Oblique facial cleft: results from
failure of the maxillary
prominence to fuse with the
lateral nasal prominence.
Cleft palate leaves the nasal and
oral cavities connected &
results in nursing problem for
the new born.
May be:
 Anterior/posterior to incisive
foramen
 Unilateral/bilateral
 Isolated/associated with cleft
lips
Cleft lip, cleft jaw
& cleft palate
Oblique facial cleft

33. Varieties of harelip

34. Developmental Anomalies of Face
Oblique facial cleft Cyclops & Proboscis

36. Cleft lip coupled with clefts of the anterior palate or
entire palate

37. Varieties of cleft palate

38. Other Anomalies
• Mandibulofacial dysostosis (Treacher
Collins syndrome)
• Retrognathia & agnathia
• Hypertelorism

39. REFERENCES
1. Langman’s Medical Embryology, 11th
Edition.
3. I.B. Singh. Human Embryology, 10th
Edition.

40. MCQs
1. The median part of upper lip is formed by:
a) Frontonasal process
b) Medial nasal process
c) Lateral nasal process
d) Maxillary process

41. MCQs
2. Oblique facial cleft result from:
a) Non-fusion of maxillary and lateral nasal process
b) Non-fusion of maxillary and medial nasal process
c) Non-fusion of maxillary and mandibular
processes
d) Non-fusion of 2 mandibular processes

42. MCQs
3. Palatal process is an outgrowth from:
a) Maxillary process
b) Medial nasal process
c) Mandibular process
d) Frontonasal process

43. MCQs
4. Premaxilla is derived from:
a) Maxillary process
b) Medial nasal process
c) Mandibular process
d) Frontonasal process

44. MCQs
5. The pharyngeal arches which are responsible for
development of external ear are:
a) 1st and 2nd
b) 2nd and 3rd
c) 3rd and 4th
d) 4th and 6th