Vulnerability of the palate to deformation.

Sir .—The recent discussion of palatal grooves in orally intubated newborns 1 supplied additional evidence that prolonged disturbances in the normal forces affecting the developing palate can deform it. We have noted deeply grooved palates in children with abnormal muscle tone from neuromuscular disorders. Precedence in this observation must be given to others, 2 however, who suggested the grooved palate was caused by abnormal forces generated by perioral musculature. As neuromuscular disorders, eg, cerebral palsy, may occur in children intubated in infancy, a deeply grooved palate should be interpreted cautiously. In such cases it may be difficult to separate the factors affecting the palatal shape; the final configuration is more likely the result of the duration and degree of the abnormal forces rather than the specific entity causing the changes. The significance of acquired palate deformities for a child's facial appearance and the contribution to language, otological, 3 and psychological