Development of the Face,

Nose & Palate

Development of the Face
Development of face- introduction
• The development of the face occurs mainly
between 5 – 8 weeks
• The lower jaw (mandible) is the first to form
(4th week)
• The facial proportions develop during the fetal
period (9th week to birth)
• During infancy & childhood, following the
development of teeth and paranasal sinuses,
the facial skeleton increases in size and
contribute to the definitive shape of the face
Embryo at 4-5 weeks (Lateral view)
Development of face- 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
Early in the 4th week, five primordial swellings consisting primarily of neural crest-
derived mesenchyme appear around the stomodeum and play an important role in
the development of face

1 Frontonasal prominence

2 Maxillary prominences

2 Mandibular prominences

Stomodeum
• 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

Lateral view
• The mesoderm of the five
prominences is continuous
with each other
• There is no internal division
corresponding to the grooves
demarcating the prominences
externally
• All five processes fuse with
each other, forming fore head,
nose, upper lip, lower lip, chin
and cheeks.
• The neural crest cells migrate
and form the facial bones.
• The pharyngeal arches I & II are
responsible for the face
development.
The structures arising from the frontonasal process.

• 1. Fore head
• 2. Upper eyelid
• 3. Nose
• 4. Philtrum

9
The structures arising from the maxillary processes
• 1. lower eyelid
• 2.lateral part of upper lip
• 3.cheek

The structures arising from the mandibular processes

•1. lower lip
•2. chin
10
 Stomodeum
• An ectoderm lined depression
• Separated from the primitive pharynx by the buccopharyngeal
(oropharyngeal) membrane
• The membrane later breaks down and stomodeum opens into
the pharynx

Forms the
vestibule of the
oral cavity
 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.
• By the end of 4th week,
bilateral oval-shaped
ectodermal thickenings
called ‘nasal placodes’
appear on each side of the
lower part of the
frontonasal prominence Frontonasal
prominence
• Nasal placodes are
primordia of the nose and
nasal cavities.
• Mesenchymal cells proliferate at
the margin of the placodes and
produce horse-shoe shaped
swellings around these.
• The sides of these swellings are
called ‘medial’ and ‘lateral’ nasal
prominences
• The placodes now lie in the floor of
a depression called ‘nasal pits’

Each lateral nasal prominence is separated from

the maxillary swelling by nasolacrimal groove
• The maxillary prominences
continue to increase in size
and:
• Laterally, merge with the
mandibular prominences to
form the cheek
• Medially, compress the
medial nasal prominences
toward the midline and
finally fuses with these to
form the upper lip.
 Development of lips

• Lower lip :The mandibular processes of the two sides

grow towards each other and fuse in the midline ,they
form the lower margin of the stomatodeum .

• Upper lip :Each maxillary process now grows medially

and fuses, first with the lateral nasal process and the
with the medial nasal process.
Formation of upper lip
Formation of lower lip
LIPS & GINGIVA

• A linear thickening of ectoderm

(Labiogingival lamina) grows
into the underlying
mesenchyme.
• Degeneration of this lamina,
forms the labiogingival groove
between the lips and gingiva.
• A small part of this lamina
persists in the median plane as
(frenulum of the upper lip).
Formation of Cheeks
 EARS
• Initially the external ears are in the neck and they ascend to be besides
the eyes as the mandible is developed.
 EARS
• Appear in the 5th week as six small mesenchymal swellings
(auricular hillocks) around the 1st pharyngeal groove.
• They are three on each side.
• These are the primordia of the of the auricles and the external
auditory meatus.
 EARS

• The external ear forms around the first branchial groove which
deepens to become the external acuostic meatus .

• Malleus and Incus are derived from the dorsal end of the first
branchial arch cartilage –MECKEL’S CARTILAGE.
• Stapes arise from the dorsal end of the second branchial arch
cartilage-
REICHERT’S CARTILAGE.

• This is the first sensory organ to begin development .

 THE MUSCLES OF THE FACE
• The mesenchyme in the 1st pharyngeal arch gives
muscles of mastication which are innervated by
the mandibular nerve.
• The mesenchyme in the 2nd pharyngeal arch gives
the muscles of facial expression which are
innervated by the facial nerve.
Development of the Nasal Cavity &
Paranasal Sinuses
Formation of External nose
 Formation of Nasal cavity
• With the formation of the
medial and lateral nasal
prominences, the nasal
placodes lie in the floor
of depressions called the
nasal pits
• By the end of 6th week,
nasal pits deepen and
form nasal sacs
• Each nasal sac grows
dorsocaudally, ventral to
the developing brain
• Initially the nasal sacs
are separated from the
oral cavity by oronasal
membrane.
• The oronasal membrane
ruptures by the 7th
week, communicating
the primitive nasal
cavities with the oral
cavity
• These communications are
called the primitive choanae
and are located posterior to
the primary palate
• After the development of
the secondary palate, the
choanae change their
position and become
located at the junction of
nasal cavity and the
pharynx.
• The nasal septum
develops as a
downgrowth from the
internal parts of
merged medial nasal
prominences
• Fuses with the palatine
process in 9-12 weeks,
superior to the hard
palate primordium
Nasal Septum & Palate

The nasal septum fuses with the midline region of the definitive palate.
• The superior, middle and
inferior conchae develop
on the lateral wall of each
nasal cavity
• The ectodermal
epithelium in the roof of
each nasal cavity
becomes specialized as
the olfactory epithelium
• The olfactory cells of
the olfactory
epithelium give origin
to olfactory nerve
fibers that grow into
the olfactory bulb
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.
3 months old fetus, showing ethmoid
& maxillary sinuses
 Nasolacrimal duct
• Develops from a rod-like thickening of the ectoderm in the floor of the
nasolacrimal groove
• This solid cord of cells separates from the surface ectoderm and lies in
the underlying mesenchyme
• The cord gets canalized to form the nasolacrimal duct
• The cranial end of the duct expands to form the lacrimal sac
• The caudal end opens into the inferior meatus of the nasal cavity
• The duct is usually becomes completely patent only after birth
• Failure of complete canalization of the duct leads to atresia of the duct
(seen in about 6% of newborn infants)
Development of Palate
(Palatogenesis)
The medial nasal swellings
enlarge, grow medially and
merge with each other in the
midline to form the
intermaxillary segment.

Human embryo: 7 weeks

 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).
 Palatogenesis
• 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.

The palate develops from two primordia:

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

Primary
palate

Hard palate
Secondary
palate

Soft palate
 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.
• 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
• 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
• 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
Embryological subdivisions of the palate
 Changes in Face during Fetal period
• Mainly result from changes in the
proportion & relative positioning of
facial structures
• In early fetal period the nose is flat and
mandible underdeveloped. They attain
their characteristic form during fetal
period
• The enlargement of brain results in the
formation of a prominent forehead
• Eyes initially appear on each side of
frontonasal prominence move medially
• Ears first appear on lower portion of
lower jaw, grow in upper direction to
the level of the eyes

•
Anomalies related to Face, Nose &
Palate
 Congenital anomalies
Anomalies of the mouth :
Microstomia : small mouth opening
Macrostomia : large mouth opening
Agnathia : absence lower jaw
Micrognathia : small lower jaw Microstomia and single nostril

Anodontia : absence of the teeth

Anomalies of the nose :

Stenosis of nostrils
Macrostomia
Deviation of the nasal septum
Facial clefts
Failure of the embryonic facial
prominences to fuse properly

• May be unilateral or bilateral

• May involve: Lead to
▪ Lips only: Cleft lip difficulty in
▪ Palate only: Cleft palate breathing
▪ Lip & palate: Cleft lip & palate
feeding
▪ Region of nasolacrimal groove: Facial clefts
sucking
swallowing
&
speech
• 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 Median Cleft lip
medial nasal prominence on the
affected side.
• Bilateral cleft lip: results due to
failure of maxillary prominences Unilateral cleft lip
to meet and unite with the
medial nasal prominences on
both sides.

Bilateral cleft lip

2. Oblique facial cleft: results
from failure of the maxillary
prominence to fuse with the
lateral nasal prominence
3. Cleft palate leaves the nasal
and oral cavities connected & Oblique facial cleft
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
Varieties of harelip
Developmental Anomalies of Face

Oblique facial cleft Cyclops & Proboscis

Varieties of cleft palate
 Other Anomalies

• Mandibulofacial dysostosis (Treacher Collins syndrome)

• Retrognathia & agnathia
• Hypertelorism
• Fusion dermoid: Cystic swelling developed along line of fusion of face
Thank
YOU