Summary about Disease
Submucosal cleft palate (SMCP) is a type of cleft palate where the palate appears intact, but there is an underlying defect in the muscles of the soft palate and/or the bony hard palate. This means the roof of the mouth looks normal, but the muscles responsible for speech and swallowing don't function correctly. It's often discovered later in life than overt cleft palates, frequently presenting with speech problems or feeding difficulties.
Symptoms
Difficulty with speech (hypernasality, nasal emission)
Feeding difficulties in infancy (poor latch, milk coming out of the nose)
Recurrent ear infections
Velar dimple (a notch or depression in the soft palate)
Bifid uvula (a split uvula)
Zona pellucida (a bluish discoloration in the midline of the soft palate)
Snoring or sleep apnea
Causes
Submucosal cleft palate, like other clefts, occurs during fetal development. The exact cause is multifactorial and not fully understood, but it's thought to involve a combination of genetic and environmental factors. These factors interfere with the normal fusion of the palate during pregnancy.
Medicine Used
There isn't a specific medicine to treat submucosal cleft palate. Treatment focuses on addressing the symptoms and may involve:
Antibiotics: For ear infections.
Speech Therapy: To improve speech and language skills.
Pain relievers: Post-surgery, as needed.
Is Communicable
No, submucosal cleft palate is not communicable. It is a congenital condition, meaning it is present at birth and not caused by an infectious agent.
Precautions
Since it's a birth defect, there aren't specific precautions to prevent submucosal cleft palate after birth. However, during pregnancy, the following are general recommendations:
Prenatal care: Regular check-ups with a healthcare provider.
Folic acid supplementation: Before and during pregnancy.
Avoidance of smoking and alcohol: These can increase the risk of birth defects.
Manage underlying medical conditions: Such as diabetes, under the guidance of a doctor.
How long does an outbreak last?
Submucosal cleft palate is not an infectious disease, therefore there are no outbreaks.
How is it diagnosed?
Diagnosis usually involves a physical examination by a pediatrician, otolaryngologist (ENT), or plastic surgeon. Key diagnostic features include:
Visual Examination: Assessing the palate for a bifid uvula, velar dimple, or zona pellucida.
Palpation: Feeling for a notch in the posterior border of the hard palate.
Speech Evaluation: Assessing for hypernasality and nasal emission.
Nasopharyngoscopy: A flexible scope is used to visualize the nasal cavity and palate during speech.
Timeline of Symptoms
Infancy: Feeding difficulties may be noticed early on.
Toddler/Preschool: Speech problems (hypernasality) become apparent as the child starts to speak.
Childhood/Adolescence: Recurrent ear infections may occur. Diagnosis may be delayed until speech issues significantly impact communication.
Important Considerations
Early Diagnosis and Intervention: Prompt identification and treatment are crucial for optimal speech development and preventing complications.
Multidisciplinary Team: Management requires a team approach involving surgeons, speech therapists, audiologists, and other specialists.
Surgical Correction: Surgery (e.g., Furlow palatoplasty) may be necessary to reconstruct the palate muscles and improve speech.
Long-Term Follow-Up: Ongoing monitoring is important to address any residual speech issues or other complications.