Integrated Vascular Architecture of the Hard Palate and Musculovascular Organization of the Upper Lip:Surgical Relevance in Cleft Reconstruction
Sebastian Andreas Gschwindt
Dental Research Division
Dr. Varga Gábor
SE, Elméleti Orvostudományi Centrum, Hevesy György előadóterem
2026-06-23 13:30:00
Dental Research
Dr. Varga Gábor
Dr. Arvin Shahbazi Irani
Dr. Huszár Tamás
Dr. Boa Kristóf
Dr. Hermann Péter
Dr. Géczi Zoltán
Dr. Nagy Katalin
This dissertation investigated the vascular collateral networks of the hard palate and the musculovascular architecture of the nasolabial region, with direct relevance to cleft and reconstructive surgery. Given the global prevalence of cleft lip and palate, a detailed anatomical understanding is essential for optimizing surgical outcomes. Our studies provided a comprehensive morphological analysis of vascular and muscular patterns with direct clinical relevance for cleft repair.
By utilizing advanced anatomical techniques—including embalming methods, latex injection, and corrosion casting—both intra- and extraosseous vascular pathways of the hard palate and alveolar aspects, as well as the musculovascular patterns of the upper lip, were delineated and investigated.
In the normal hard palate and alveolar regions, extensive intra- and extraosseous collateral networks were identified, supporting robust collateral perfusion. In contrast, the cleft specimen demonstrated altered vascular patterns, including enlargement and lateral displacement of the GPA, absence of key anastomoses within the cleft zone, and more perpendicular orientation of arterial branches toward the cleft margins, thereby emphasizing the need for preservation of the dominant vascular supply during surgical intervention.
In the study of the myrtiform area, the MMS was defined as a consistent anatomical entity with W- or V-shaped configurations and significant vascular variability, characterized by unilateral dominance of the SLA and compensatory contributions from adjacent arterial systems. The findings highlighted the importance of recognizing musculovascular organization and compensatory perfusion patterns in clef lip-nose repair.
Based on our determinations a comprehensive anatomical foundation for a more anatomically guided approach in cleft surgery. The findings emphasize that surgical planning should be tailored to the underlying musculovascular architecture, with particular attention to preserving key vascular pathways and respecting muscle orientation. Such an approach may contribute to improved tissue viability, enhanced wound healing, and more predictable functional and aesthetic outcomes in cleft repair.
