Submucous cleft palate: from diagnosis to management

Abstract

This retrospective study, following approval of the institutional review board (GO 17/633-31), was conducted at Hacettepe University Cleft Lip and Palate, Craniomaxillofacial Anomalies Research, Treatment and Application Center; currently, the only officially approved Background/aim: The aim of this study was to investigate submucous cleft palate (SMCP) patients in order to document the age of diagnosis, cause of referral, symptoms and palate findings, objective evaluation of nasalance and velopharyngeal dysfunction (VPD), and intervention type. Material and methods: The archive of Hacettepe University Cleft Lip and Palate, Craniomaxillofacial Anomalies Research, Treatment, and Application Center was reviewed retrospectively, and 166 patients diagnosed with SMCP were documented. Results: The mean age of the patients at the time of initial referral was 10 years and 3 months ± 8 years and 5 months with the youngest being 1 month and the oldest 44 years old. The primary complaint of 127 (76.5%) patients was speech disorder. Seventy-nine patients underwent surgery, and the mean age was determined as 10 years ± 6 years and 8 months. Conclusion: The diagnosis of SMCP continues to be rather late, being delayed until a prominent speech disorder is present. Studies for the awareness of health professionals are of great importance for the early diagnosis and intervention of SMCP in order to prevent adverse effects.

A Challenging Period After Repair: Etiology and Follow-Up Rates of the Patients With Cleft Lip and Palate in Intensive Care Unit

“…However, in this study, further data such as etiology of ICU/high dependency unit admission, the type of the admission (expected/unexpected), the association of the cleft type with admission, treatment/follow-up protocol in the ICU have not been examined. The higher rate of ICU admission and the long stay in the ICU of the present study is attributed to admissions and consultations of the challenging patients to our clinic, as our hospital is a tertiary healthcare center and is the referral hospital for CLP management with a comprehensive cleft team 18–21 . Furthermore, as reported in the literature that extubation and early follow-up in the ICU are influential on the prevention of postoperative morbidities 7,17 .…”

“…The higher rate of ICU admission and the long stay in the ICU of the present study is attributed to admissions and consultations of the challenging patients to our clinic, as our hospital is a tertiary healthcare center and is the referral hospital for CLP management with a comprehensive cleft team. [18][19][20][21] Furthermore, as reported in the literature that extubation and early follow-up in the ICU are influential on the prevention of postoperative morbidities. 7,17 Therefore, in the present study, high-risk patients with concomitant abnormalities and syndromic patients were transported to the ICU for recovery and observation.…”

Furlow Palatoplasty and Tonsillectomy for Treating Patients With Submucous Cleft Palate and Tonsillar Hypertrophy: A One-Stage Procedure

“…A uthors should be congratulated on their work as few studies have been published regarding the management of tonsil hypertrophy during primary palatoplasty in patients with cleft palate. The submucous cleft of the palate occurs in ~1/1200 children 1 and results from a lack of normal fusion of the muscles within the soft palate. This type of cleft may be associated with morphologic and functional problems owing to upper airway disorders.…”

“…A submucous cleft palate (SMCP) is a hidden type of palatal cleft with characteristic anatomical findings. 1 It is diagnosed based on 3 features: bifid uvula, bluish midline of the soft palate, and bifid posterior part of the hard palate. 2 It has an incidence rate of ~1 in 1250 of the general population.…”

“…A patient with SMCP may be asymptomatic throughout the life or exhibit symptoms at any age. 1 Few studies have reported that > 50% of children with SMCP may develop velopharyngeal insufficiency (VPI). However, these studies have been undertaken in tertiary-referral cleft palate centers; therefore, the true percentage of symptomatic SMCP that requires surgery may be lower.…”