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Many submucous cleft palate symptoms should be taken into account. This condition can affect a person’s speech, dental hygiene, and swallowing ability. In fact, this type of cleft palate may result in ear infections, so try going to an ENT surgeon if your child develops ear problems. Other issues associated with the submucous cleft palate are sinusitis and sleep apnea. This blog post will cover the submucous cleft palate treatment options and how it affects these different aspects of someone’s health.
What is a Submucous Cleft Palate
A submucous cleft palate is a birth defect that affects the roof of the mouth. It occurs when the soft palate or tissue between the mouth and nose does not fuse properly during development, leaving a small opening in the roof of the mouth. In any case, this condition does not always involve a cleft in the hard palate. Furthermore, a submucous cleft palate occurs when failure of fusion of the palatal shelves during fetal development results in a bifid uvula and submucous cleft palate/nasal cavity. This can cause problems with speech and swallowing.
Causes of a Submucous Cleft Palate
A submucous cleft palate (SMCP) is a form of submucosal cleft palate. Some portion of the soft palate fails to fuse properly. There are two types: submucous and overt. A submucous cleft palate can be seen as a grove or furrow on an endoscopic exam but cannot be seen from the outside.
In any case, there are many different causes of the submucous cleft palate. Some include:
Genetics: This type of cleft palate is more likely to occur in families where the condition occurred before.
Environmental Factors: The condition is most common between 16-22 weeks gestation. This means submucous cleft palate may be caused by exposure to toxins like alcohol or certain medications like Accutane.
Maternal Health: Submucous cleft palate is more common in infants born to mothers with diabetes and those who smoke.
Birth: This cleft palate type may occur due to fetal distress, prolonged labor, or if the infant’s head is rotated upon delivery.
Previous Surgery: Submucous cleft palate may result if the tissue is damaged during surgery.
Complications From Cleft Palate Treatment: Submucous cleft palate will not heal independently. Treatment must be performed to close the split in the membrane. If this treatment is unsuccessful submucous cleft palate can reoccur.
In some cases, this issue may occur for unknown reasons.
Symptoms of Submucous Cleft Palate
Some symptoms of submucous cleft palate:
Speech problems
Speech articulation problems, such as abnormal nasal speech, are common in a submucous cleft palate. This is because the roof of the mouth is not formed correctly. You can book an appointment to a professional to check the different methods to improve your speech issues.
Feeding problems
This type of cleft palate is associated with feeding problems in babies. This is because they have difficulty sucking and swallowing.
Nasal congestion
This condition can lead to nasal congestion because the tissues that separate the nasal passages and the mouth are not formed properly.
Frequent ear infections
As a matter of fact, ear infections are prevalent in children with submucous cleft palates. This is because the opening in the roof of the mouth can allow bacteria and other germs to enter the middle ear. Ear infections can cause pain, fever, and drainage from the ear.
Delayed adolescence speech development
This is common in children with submucous cleft palates. This is because the opening in the roof of the mouth can cause difficulty pronouncing certain sounds.
Sleep apnea
In some cases, a submucous cleft palate can cause sleep apnea. This condition happens when breathing stops during sleep. The submucous cleft palate can damage the soft palate, uvula, or tongue root. Talk to your dentist if issues like sleep apnea occur.
Cleft lip nose deformity
Cleft lip nose deformity is a condition in which the nose is misshapen due to an opening in the roof of the mouth. This opening can cause problems with eating, speaking, and breathing. Cleft lip nose deformity is a common symptom of the submucous cleft palate.
Dental problems
Dental problems are common in people with submucous cleft palate. This cleft palate type can cause difficulty swallowing, leading to food being lodged in the teeth. Food left in the teeth for a long time can cause tooth decay and gum disease. Visit a dental provider like Coorparoo’s trusted clinic, Complete Dental, to address your child’s dental issues like this.
Poor weight gain
Weight gain is not always easy if a submucous cleft palate is present. This is because this cleft palate can affect the function of the esophagus, stomach, and intestines. Because the submucous cleft palate does not allow food to pass through properly, resulting in slower weight gain than expected.
Sudden submucous cleft palate in adults
Submucosal cleft palate in adults is rare, but it can cause difficulty swallowing and breathing if it occurs. This is because the submucous cleft palate affects the function of the soft palate and uvula, which are used to pass food into the esophagus during swallowing.
The symptoms for submucous cleft palate can vary but often include feeding difficulty, speech problems, and frequent ear infections. In some cases, this condition can also cause respiratory problems.
If you believe your child may have a submucous cleft palate, please contact your pediatrician for a diagnosis. Treatment options vary depending on the severity of the condition. Still, they may include speech therapy, surgery, and/or braces. Early diagnosis and treatment are essential for the best possible outcome for a submucous cleft palate.
How is Submucous Cleft Palate Treated?
There is no one-size-fits-all treatment for the submucous cleft palate. Treatment will vary depending on the symptoms and severity of the cleft. In general, treatment may include:
Speech Therapy
Speech therapy is often recommended for children with this cleft palate issue to improve their articulation. In fact, this therapy aims to improve velopharyngeal closure and reduce hypernasality. Hearing aids may be necessary in severe submucous cleft palate cases.
A few different types of submucous cleft palate surgery can be done to treat the symptoms. These surgeries may include:
Palatoplasty
This is the most common surgery for the submucous cleft palate. Palatoplasty is a surgery to repair the palate. It can be done either through the mouth or through a small incision in the neck.
Maxillary advancement
After submucous cleft palate surgery, the maxilla is typically brought forward. This can be done by wearing a maxillary expander device for about 8-12 weeks.
Alveolar bone grafting
A submucous cleft palate can cause crooked teeth or gaps between the teeth. This is because of a lack of bone to support them. In alveolar bone grafting, the doctor removes the existing bone and replaces it with a block of donated bone which encourages new bone growth to create a strong foundation for teeth.
Nasopharyngoplasty
This surgery improves people’s nose and throat function with submucous cleft palate. It can be done through the nose or through a small incision in the neck.
Labiolingual flap repair
This surgery improves the mouth’s function in people with submucous cleft palate. Professionals usually perform this on one side because the submucous cleft palate is usually not symmetrical.
Palatal lengthening procedure (PLP)
The soft tissue that separates the nasal passages from the mouth can be missing in the submucous cleft palate. This surgery lengthens this tissue and improves the submucous cleft palate symptoms.
Pharyngeal flap surgery
This surgery improves the mouth’s function in people with submucous cleft palate. It usually only needs to do on one side because the submucous cleft palate is usually not symmetrical.
Velopharyngeal insufficiency (VPI) surgery
VPI surgery is a type of surgery that treats submucous clefts caused by trauma. This surgery can help to improve the function of the mouth and throat. It is usually only necessary on one side because the submucous cleft palate is usually not symmetrical.
Surgery for submucous clefts caused by trauma
If the submucous cleft palate happens because of trauma, surgery may be necessary to repair the damage.
Generally, submucous cleft palates are malformations of the roof of the mouth. Before performing any surgical treatment, a palate expander may be necessary, so it’s easier for patients to consume food during their cleft palate journey.
Furthermore, the primary goals of submucous cleft palate surgical treatment are to achieve velopharyngeal closure, reduce hypernasality and restore nasal airway.
Prevention for a Submucous Cleft Palate
There is no known way to prevent the submucous cleft palate. However, pregnant women need to seek prenatal care when they realize they are pregnant. This will help ensure that their doctors detect and treat early any potential problems. If the doctor diagnoses a submucous cleft palate during pregnancy, they may recommend a C-section at delivery. This is to avoid any trauma to the infant during labor and delivery.
A submucous cleft palate is a common birth defect that forms during pregnancy’s third and fourth months. The primary cause of submucous cleft palate is not clear. However, many experts believe this condition occurs when the two plates of tissue do not join entirely in forming the mouth and nose. Doctors usually discover a submucous cleft palate at birth or within a few months.
It is essential to recognize the submucous cleft palate as early as possible for comprehensive treatment and an effective long-term prognosis.
Conclusion
You can better understand your child’s diagnosis by understanding the symptoms, treatment options, and prognosis for submucous cleft palate. This is important because it will help you decide what type of surgery to pursue and how aggressively they need treatment like speech therapy or other intervention.
You can also ask your dentist’s recommendations about other possible ways to improve this condition. Knowing about the surgical procedure is also helpful to prepare them psychologically for any potential pain during recovery. So there won’t be a lot of surprises after they go under anesthesia. Finally, knowing the long-term outlook will relieve you from feeling like everything hinges on this one decision. Remember that there are many ways that children who have had this surgery do just fine.
References:
Submucous Cleft Palate.
https://kidshealth.org/en/parents/submucous-cleft-palate.html
What Is Speech Therapy?
https://www.parents.com/kids/development/learning-disabilities/what-is-speech-therapy/
Palatoplasty.
https://www.sciencedirect.com/topics/medicine-and-dentistry/palatoplasty