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Published on: September 19, 2015
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Late detection of cleft palate
K H Hanny1, I A C de Vries2, S J Haverkamp3
1Department of Paediatric Plastic Surgery, Wilhelmina Children's Hospital, University Medical Centre, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
European Journal of Pediatrics
|August 2, 2015
Summary
Late diagnosis of cleft palate only (CPO) is common, impacting development. Early detection, especially for severe clefts, is crucial. Healthcare professionals need enhanced intra-oral examination awareness to improve CPO diagnosis rates.
Area of Science:
- Pediatric Congenital Malformations
- Craniofacial Surgery
- Speech and Hearing Sciences
Background:
- Cleft palate only (CPO) is a frequent congenital anomaly impacting feeding, speech, hearing, and development.
- Submucous clefts are particularly prone to underdiagnosis due to detection challenges, with literature indicating diagnoses as late as 4.9 years on average.
- Late diagnosis of CPO can lead to significant feeding, growth, speech, and hearing impairments.
Purpose of the Study:
- To retrospectively determine the age of diagnosis for Cleft Palate Only (CPO).
- To investigate the correlation between the presence of syndromes and other factors with the age of CPO diagnosis.
- To identify factors influencing the timeliness of CPO diagnosis.
Main Methods:
- Retrospective analysis of Cleft Palate Only (CPO) cases diagnosed between 1997 and 2014.
- Statistical analysis including Kaplan-Meier survival analyses to assess diagnosis timing.
- Correlation analysis to evaluate the impact of syndromes and cleft severity on diagnosis age.
Main Results:
- The mean age of diagnosis for CPO was 1 year and 4 months, with 37.3% diagnosed after 30 days and 24.8% after 12 months.
- Submucous clefts were diagnosed significantly later, with 89.3% detected after 30 days (p=.000).
- Earlier diagnoses were associated with increased cleft severity (grades 1-4) and the presence of associated disorders.
Conclusions:
- Cleft Palate Only (CPO) is frequently diagnosed late, potentially delaying necessary interventions.
- Healthcare professionals, including midwives and pediatricians, require heightened awareness and improved intra-oral examination techniques for early CPO detection.
- Thorough visual and manual palatal inspections are recommended to improve the detection rates of all cleft types, particularly submucous clefts.
