title: Malformation of the vomer in submucous cleft palate.
abstract: BACKGROUND
  Several criteria are described in the literature to diagnose a submucous cleft palate. Commonly the differences in the extent of the submucous cleft will not be as overt as in open clefts. Nevertheless, complete submucous cleft palate may cause imperfect palato-pharyngeal closure so that the affected person needs to undergo speech training and surgical treatment.
  
  
  METHODS
  We investigated 30 patients who underwent palatal repair to correct this disorder. They were evaluated according to the Koch's documentation system.
  
  
  RESULTS
  In all patients an additional malformation of the inner nose was found: The vomer was not fused with the palatal shelves. There were different degrees of severity of this vomerine malformation and they were not necessarily correlated with the extent of the palatal cleft.
  
  
  CONCLUSIONS
  In our opinion, this malformation of the vomer should be seen as a typical symptom of classical submucous cleft palate. Discussion is needed on how the vomerine malformation should be incorporated into the surgical procedure. Since we know from septal surgery that a basal septal perforation will lead to disturbances of nasal breathing.
authors.affiliation: Division of ENT, DRK Childrens' Hospital, Siegen, Germany. grzonka@gmx.de
authors.forename: M A
authors.initials: MA
authors.lastname: Grzonka
authors.forename: K H
authors.initials: KH
authors.lastname: Koch
authors.forename: J
authors.initials: J
authors.lastname: Koch
authors.forename: S
authors.initials: S
authors.lastname: Glindemann
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000145:classification* / Q000473:pathology / Q000601:surgery; D005205:Fascia / Q000002:abnormalities / Q000473:pathology; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009300:Nasal Septum / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D010156:Palatal Muscles / Q000002:abnormalities / Q000473:pathology / Q000601:surgery; D021362:Palate, Hard / Q000002:abnormalities / Q000473:pathology / Q000601:surgery; D010160:Palate, Soft / Q000002:abnormalities / Q000473:pathology / Q000601:surgery