The use of the TBX22null mouse model to investigate submucous cleft palate development and therapy
Many genetic strains of mice develop a cleft palate. Those with complete cleft palates do not survive because they cannot feed but the TBX22null strain has a submucous cleft palate and does survive.
It is possible to observe the process of palate closure in the fetus by culturing the palate in tissue medium. Dr Rimante Seselgyte is funded by CLEFT to carry out a PhD study involving research into these mice. It is planned to see if the addition of growth factors or stem cells to the fusing palate can improve closure and muscle function. If effective, there is then the potential to use these factors in human palate repair in an attempt to enhance outcomes particularly for submucous cleft palate.
£55,000 is needed to complete this project.
Trying to improve the quality of the surgery by understanding what the muscles of the soft palate do: A study of the muscles of the soft palate
Research in the UK has shown that across the country about 25% of children having repair of cleft palate require further surgery because the palate is not long enough and/or mobile enough to close off the palate against the back of the throat. This means that air escapes during speech and children often develop abnormal speech patterns as they try to compensate. The North Thames Cleft team has pioneered the use of the operating microscope for cleft palate repair and has improved on these results but there is still progress to be made. There are many gaps in our knowledge of the anatomy and function of the soft palate muscles.
Dr Leila Rees has been studying the anatomy and function of the soft palate muscles for a PhD. She and Brian Sommerlad have performed some anatomical dissections and Leila has carried out a microscopic study of the muscles of the palate. Leila has worked with Professor Phil Stanier and Dr Erwin Pauws in studying the muscles in mice with syndromes which produce conditions like cleft palate. We hope that this will increase our understanding of the all- important palate muscles which are essential for speech.
This is a 3 year project, which has the potential to improve the quality of results following palate repair in our own centre and with the resulting information also being passed on to centres throughout the world.
3-D Imaging project
CLEFT has provided £7,500 towards a pilot project with Dr. Malcolm Birch (Director of Clinical Physics at The Royal London Hospital) to develop techniques for 3-D MRI scanning of the palate.
Medical explanation: Current investigations of palate function involve either X-rays or endoscopy (looking with a telescope at how the palate is functioning). Neither of these investigations gives a three-dimensional view and neither allows the muscles of the palate to be identified.
MRI techniques have improved over recent years and offer the potential for a much better understanding of the function of the palate and its individual muscles. It is hoped that the three-dimensional anatomical information which MRI can offer will enable more comprehensive pre- and post-operative assessments of cleft patients and improve our understanding of how the palate functions.