The Association of Submucous Cleft Palate and Clefting of the Primary Palate

Abstract

478 records of patients with cleft palate were reviewed to determine the prevalence and significance of submucous cleft palate associated with Clefting of the primary palate. The prevalence of submucous cleft palate in the 71 patients with clefts of the primary palate (SMCP-CL) was 13 per cent. This is two to three times greater than the prevalence of isolated submucous cleft palate found in cleft palate clinic patients. Patients with SMCP-CL often had the symptoms of velopharyngeal incompetence (VPI) and middle ear disease. The increased prevalence of SMCP and frequent symptomatology of patients with Clefting of the primary palate make it essential that patients with Cleft lip have early, thorough evaluation for SMCP. Early detection of SMCP associated with cleft lip and close follow-up, permits the prevention of ear problems and the proper management of VPI should it develop. KEY WORDS: cleft palate, cleft lip, submucous cleft palate, primary palate, velopharyngeal incompetence, middle ear disease Submucous clefting of the palate (SMCP) was first described by Roux in 1825. Subsequent reports were added by Kelly (1910), Dorrance (1930), and Veau (1931). The classic diagnostic triad of bifid uvula, midline diastasis of the palatal muscles, and notching of the posterior border of the hard palate was described by Calnan in 1954. The prevalence, the nature of the defect, problems associated with SMCP, and treatment have subsequently been described (Bergstrom). One of us, Barbel Holt-mann, noted an apparent increased prevalence of SMCP in patients with clefts of the primary palate. Since information in the lit— erature concerning the prevalence of SMCP in patients with Clefting of the primary palate (SMCP—CL) was unclear, we reviewed our The authors are affiliated with the Division