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Submucous cleft palate: an often-missed diagnosis
Kim M Ha1, Heather Cleland, Andrew Greensmith
1Department of Paediatrics, University of Melbourne, Australia.
The Journal of Craniofacial Surgery
|May 30, 2013
Summary
Early diagnosis of submucous cleft palate (SMCP) is crucial for preventing speech issues. While surgical repair is successful, delayed diagnosis by physicians leads to significant speech impairment and need for further therapy.
Area of Science:
- Craniofacial Surgery
- Pediatric Otolaryngology
- Speech Pathology
Background:
- Submucous cleft palate (SMCP) presents with characteristic features, yet diagnosis is often delayed.
- A significant percentage of patients undergo unrelated surgeries before SMCP is identified.
Purpose of the Study:
- To investigate the age at diagnosis, clinical characteristics, and symptoms of SMCP.
- To compare speech outcomes following three distinct surgical repair techniques for SMCP.
Main Methods:
- Retrospective review of 92 patients diagnosed with SMCP between 1994 and 2008.
- Analysis of surgical outcomes (need for secondary procedures) and speech assessments (Great Ormond Street Speech Assessment).
Main Results:
- SMCP diagnosed at a mean age of 3.6 years; 8% were asymptomatic at diagnosis.
- Abnormal speech (67%), recurrent otitis media with effusions (49%), and hearing loss (47%) were common.
- Repair after 18 months increased the likelihood of articulatory speech errors and need for speech therapy.
Conclusions:
- Delayed diagnosis of SMCP is prevalent among physicians, despite evident signs and symptoms.
- Surgical correction is effective irrespective of technique or age at repair.
- Earlier recognition of SMCP is essential to prevent long-term speech impairment.
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