Str.—In a recent issue, Molteni and Bumstead1 compared "hard" and "soft" oral endotracheal tubes with respect to their effect on the subsequent development of a "palatal groove" in intubated newborns. I was surprised by this study because several years ago I was taught that palatal grooves in this setting are really pseudo–palatal grooves. In most newborns, the grooves represent thickening of the alveolar ridge because of restriction of tongue movement due to the presence of the oral foreign body, ie, the endotracheal tube. Broadening of the alveolar ridges then creates the false impression that the palate has been eroded by a "groove"; in fact, the palate is intact but partially obscured.
The photograph presented in the article shows an infant whose oral anatomy would appear to include a broadly widened secondary alveolar ridge and a normal-appearing midline palate. This would seem to support the conceptual construct that these