What causes a submucous cleft palate?

A submucous cleft palate (SMCP) happens when the roof of the mouth, or palate, doesn’t form properly when a baby is developing in the womb. This cleft is an opening underneath the mucous membrane, the tissue that covers the palate. A typical cleft palate is noticed when a baby is born.

How do you get a submucous cleft?

A submucous cleft palate may be identified by the presence of a bifid uvula and a notch at the back of the hard palate. However, in some children, the palate may appear normal on physical examination despite the fact that the child is experiencing speech problems, persistent ear disease, and/or swallowing difficulties.

Is submucous cleft palate rare?

A submucous cleft palate (SMCP) is a relatively rare variant of the congenital malformation cleft palate. A cleft palate is mostly noticed directly after birth during screening of the newborn. In SMCP the roof of the mouth appears normal.

Is submucous cleft palate genetic?

As with other types of clefts, a submucous cleft is caused by several factors. In most cases, there is a combination of genetics (inheritance) and environmental factors during the first few weeks of pregnancy. Submucous cleft can occur as part of a genetic syndrome that causes other congenital anomalies.

What is the primary hallmark of a submucous cleft?

The hallmark signs usually associated with submucous cleft palate are bifid uvula, V-shaped notching of the hard palate and a translucent line in the midline of the soft palate (zona pellucida) (4,5).

How do you fix a submucous cleft palate?

How Is Submucous Cleft Palate Treated?

  1. No surgical repair needed, no speech therapy needed.
  2. Surgical repair needed, no speech therapy needed.
  3. No surgical repair needed, speech therapy needed.
  4. Surgical repair needed, speech therapy needed.

How common is a submucous cleft palate?

A submucous cleft palate (SMCP) results from a lack of normal fusion of the muscles within the soft palate as the baby is developing in utero. It occurs in about 1 in 1,200 children.

What are signs of submucous cleft?

What Are the Signs & Symptoms of a Submucous Cleft Palate?

  • trouble feeding as an infant (taking a long time to feed, liquid coming through the nose, etc.)
  • chronic ear infections and effusions (fluid buildup behind the eardrum)
  • speech sound errors.
  • speech problems that make the child hard to understand.

How is an occult submucous cleft palate detected?

However, the occult submucous cleft palate does not have the classic triad of bifid uvula, hard palate bony notch, and furrow in the midline of the soft palate. Characteristic facial features, cephalmetric x-rays, and cine voice studies can help make a presumptive diagnosis of occult submucous cleft palate.

What is occult submucous cleft palate?

What’s even trickier is a diagnosis called occult submucous cleft palate, in which the hidden cleft is only visible when looking through the nose with a scope at the top of the muscle. This is because an occult submucous cleft occurs when there’s simply underdeveloped, or not enough, muscle of the uvula.

What is the difference between a submucous cleft palate and a cleft palate?

A complete cleft palate is a split in the entire roof of the mouth. An incomplete cleft palate is a split in part of the roof of the mouth. A bifid uvula is a split in the uvula. A submucous cleft palate is an opening in the muscles of the soft palate, beneath a thin layer of tissue (mucous membrane.)

What are the types of submucous cleft palate?

Submucous cleft palate (SMCP) is a subgroup of cleft palate which is often unawared by general practitioners. The diagnostic triad of (1) bifid uvula, (2) translucent zone in soft palate and (3) bony notch in the posterior edge of the hard palate can be variable in their severity among each patient.

What is submucous?

Listen to pronunciation. (sub-myoo-KOH-suh) The layer of tissue under the mucosa (inner lining of some organs and body cavities that makes mucus).

What kind of disorder is hypernasality?

What is a resonance disorder? There are three types of resonance disorders: hypernasality, hyponasality and cul-de-sac resonance. Hypernasality occurs when too much sound resonates (vibrates) in the nasal cavity (nose) during speech.

How do you fix hypernasality?

Feedback for hypernasality or nasal emission:

Ask the child to try to reduce or eliminate the sound coming through the tube as he produces oral sounds and then words with oral sounds. Have the child alternately pinch and open his nose during production of the sound.

How do you fix Hyponasality?


  1. tonsillectomy/adenoidectomy;
  2. removal of nasal polyps;
  3. surgery to correct deviated septum;
  4. surgical removal of tissue or bone of the nasal passage to treat choanal atresia; and.
  5. surgical reconstruction to enlarge stenotic nares.

What can cause hypernasality?

Hypernasal speech can be caused by anything resulting in velopharyngeal incompetence. Clefting (splitting) of the roof of the mouth (CLEFT PALATE), a palate that is too short, or the inability to move muscles involved with closure of the velopharyngeal complex (as in cerebral palsy) can cause hypernasal speech.

How do you check for Hyponasality?

Feel sides of nose for vibration that might accompany perceived hypernasality. Alternately pinch and then release the nose (sometimes referred to as the cul-de-sac test or nasal occlusion) while individual produces a speech segment—a change in resonance indicates hypernasality.

What causes hypernasality in dysarthria?

Hypernasality is the result of velopharyngeal incompetence or VPI, which is the inability of the soft palate and related musculature to close the nasopharynx (the area in the throat that separates the oral and nasal cavities).

Is hypernasality a symptom of dysarthria?

Admittedly, hypernasality represents a distinctive manifestation of certain dysarthria subtypes, particularly of flaccid dysarthria, and thus its evaluation can provide useful information in the differential diagnosis of dysarthrias (Duffy, 2013).

How is hypernasality treated in speech therapy?

The treatment of hypernasality secondary to velo- pharyngeal insufficiency may include surgical intervention, a prosthetic device, or speech therapy. It should be noted that changing velopharyngeal structure with surgery or a prosthesis does not change function. Therefore, speech therapy is indicated in most cases.