The submucous cleft palate: diagnosis and therapy.
OBJECTIVE
To investigate age of diagnosis, typical symptoms, finding of the palate, therapy options and accompanying diseases.


METHODS
A retrospective analysis of 439 patients with symptomatic submucous cleft palate (SMCP), who received a veloplasty operation (butterfly suture technique developed by Haase) was made.


RESULTS
SMCP was initially diagnosed at the mean age of 4.9 years. Main symptoms were hyper nasal speech (51%) and conductive hearing loss (45%), which resolved after veloplasty (often in combination with adenotomy and insertion of ventilation tubes). Typical findings of the palate were a lack of posterior nasal spine (68%) and bifid uvula (59%). Following surgery 17.1% required speech therapy and 5.5% needed velopharyngoplasty due to continuing hyper nasal speech.


CONCLUSIONS
SMCP is often diagnosed very late, though symptoms of velopharyngeal insufficiency (hyper nasal speech, Eustachian tube dysfunction) and bifid uvula are present. We therefore recommend that all patients with such findings are examined by an appropriate specialist such as Phoniatrics, Otolaryngologist and Oral-Maxillofacial-Surgeon so that early diagnosis and palatoplasty can be performed. The veloplasty operation (butterfly suture technique) can be recommended as a safe therapy for velopharyngeal insufficiency for patients with symptomatic SMCP.
Department of Ear, Nose and Throat Surgery, Section of Phoniatrics and Pedaudiology, University of Ulm, Ulm, Germany. rudolf.reiter@uniklinik-ulm.de
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R
Reiter
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S
Brosch
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H
Wefel
G
G
Schlömer
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S
Haase
D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000175:diagnosis* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D058753:Laryngoplasty / Q000009:adverse effects / Q000379:methods; D008297:Male; D009092:Mucous Membrane / Q000473:pathology / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010160:Palate, Soft / Q000002:abnormalities / Q000601:surgery; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D013070:Speech Therapy / Q000379:methods; D013536:Suture Techniques; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*