Our Summary

This research paper discusses submucous cleft palate (SMCP), a rare birth defect that affects the roof of the mouth and can cause speech problems. Traditionally, treatment involves delaying surgery until a specialist can assess the child’s speech, usually between ages 3-5. However, the timing of treatment, surgical methods, and any other health conditions the child might have are all important factors that can impact the success of the treatment.

Recent findings suggest that diagnosing and operating on SMCP early on can lead to better speech outcomes. Researchers are also investigating other possible reasons for performing surgery. The timing of surgery and the surgical method used might be influenced by whether the child has a specific genetic disorder called 22q11.2 deletion syndrome.

In summary, diagnosing classic and hidden forms of SMCP can be challenging and depends on the experience of the healthcare provider. Different surgical methods can be used and have been successful, but the best method might depend on any other health conditions the child has. The reasons for performing surgery and the best time to do so are areas that need further study.

FAQs

  1. What is a submucous cleft palate and how does it impact speech?
  2. What factors influence the timing of the surgical intervention for SMCP?
  3. How does the 22q11.2 deletion syndrome affect the surgical technique used for SMCP?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cleft palate surgery is to ensure early diagnosis and surgical intervention for optimal speech outcomes. It is important to discuss timing of intervention and surgical technique with your healthcare provider, especially if there are any syndromic diagnoses or comorbidities present. Follow-up with a skilled speech-language pathologist post-surgery is also crucial for monitoring progress and ensuring proper speech development.

Suitable For

Patients with submucous cleft palate (SMCP) are typically recommended for cleft palate surgery, especially if they are experiencing velopharyngeal dysfunction or speech abnormalities. Early diagnosis and surgical intervention for SMCP have been associated with improved speech outcomes. Patients with syndromic diagnoses, such as 22q11.2 deletion syndrome, may require specific surgical techniques and timing of intervention may be influenced by their comorbidities. It is important to assess each patient individually to determine the best course of action for surgical repair of SMCP.

Timeline

Before cleft palate surgery:

  1. Prenatal diagnosis: In some cases, a cleft palate may be detected during a prenatal ultrasound.

  2. Evaluation by a multidisciplinary team: After birth, the baby will be evaluated by a team of healthcare professionals including a pediatrician, plastic surgeon, speech therapist, and other specialists.

  3. Feeding challenges: Babies with a cleft palate may have difficulty feeding due to issues with sucking and swallowing.

  4. Speech therapy: Some patients may start speech therapy before surgery to help with communication skills.

  5. Surgical consultation: The patient and their family will meet with a plastic surgeon to discuss the surgical procedure, risks, and expected outcomes.

After cleft palate surgery:

  1. Recovery period: The patient will have a recovery period following surgery, during which they may experience pain, swelling, and difficulty eating and speaking.

  2. Speech therapy: After the surgery, the patient will likely continue with speech therapy to improve their communication skills.

  3. Follow-up appointments: The patient will have regular follow-up appointments with their healthcare team to monitor their healing and progress.

  4. Long-term care: Patients may require additional surgeries or interventions as they grow to address any complications or ongoing issues related to their cleft palate.

Overall, the timeline for a patient with a cleft palate before and after surgery involves a multidisciplinary approach to diagnosis, treatment, and ongoing care to ensure the best possible outcomes for the patient.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with cleft palate surgery?

  2. How long is the recovery process after cleft palate surgery?

  3. Will my child require any additional surgeries or treatments in the future?

  4. How soon after surgery can my child resume normal activities, such as eating and drinking?

  5. What kind of speech therapy or follow-up care will be needed after cleft palate surgery?

  6. Are there any long-term effects or consequences of cleft palate surgery that I should be aware of?

  7. How experienced are you in performing cleft palate surgery, and what is your success rate?

  8. Are there any alternative treatment options to consider for my child’s cleft palate?

  9. Will my child need to stay in the hospital overnight after cleft palate surgery?

  10. What can I do to help prepare my child for cleft palate surgery and ensure a successful outcome?

Reference

Authors: Dean KM, Leeper LK. Journal: Curr Opin Otolaryngol Head Neck Surg. 2020 Dec;28(6):410-413. doi: 10.1097/MOO.0000000000000673. PMID: 33105231