Information about Submucous Cleft Palate
What is submucous cleft palate? How can a submucous cleft palate be
A submucous cleft palate is one type of cleft
palate. The word “palate” refers to the roof of The most common reason that a child is
the mouth and the term “cleft” indicates a split evaluated for a submucous cleft palate is
in the palate. The palate consists of both a abnormal nasal speech. Other symptoms may
bony portion (hard palate) and a muscular include persistent middle ear disease and
portion (soft palate). At the end of the soft feeding/swallowing difficulties. A submucous
palate, the small finger-like projection of tissue cleft palate may be identified by the presence
that hangs down is called the “uvula.” The term of a bifid uvula and a notch at the back of the
“submucous” refers to the fact that the cleft is hard palate. However, in some children, the
covered over by the lining (mucous membrane) palate may appear normal on
of the roof of the mouth. This covering of
mucosa makes the cleft difficult to see when physical examination despite the fact that the
looking in the mouth. child is experiencing speech problems,
persistent ear disease, and/or swallowing
A submucous cleft of the soft palate is difficulties. In such cases, special tests are
characterized by a midline deficiency or lack of necessary to fully assess the palate. These
muscular tissue and incorrect positioning of the tests include x-ray examination and
muscles. A submucous cleft of the hard palate nasopharyngoscopy (looking at the palate
is defined as a bony defect in the midline or through a very small tube that is placed in the
center of the bony palate. This can sometimes nose). These evaluations are most commonly
be felt as a notch or depression in the hard done by members of a cleft palate team. If you
palate. Often a submucous cleft palate is suspect your child has a submucous cleft, you
associated with a cleft (or “bifid”) uvula. should contact a local cleft palate team.
What are the effects of submucous cleft Should a submucous cleft be treated?
Submucous cleft palate only requires surgery if
When a submucous cleft is present, the it is causing problems for the individual. The
muscles of the soft palate may not function most common reason for treating a person with
properly which places the individual at risk for a submucous cleft palate is because of
speech problems, middle ear disease, and abnormal, nasal-sounding speech. In such
swallowing difficulties. However, there are cases the child’s speech should be evaluated
some individuals with a submucous cleft who by a speech pathologist who, in consultation
have no apparent problems. Of importance to with other professionals on the cleft palate
all persons with the submucous cleft, and their team, can diagnose the cause of the problem.
family, is the knowledge that submucous cleft If the individual cannot prevent air from
has the same genetic (hereditary) risk as an escaping through the nose during speech, a
obvious cleft of the palate. condition called velopharyngeal incompetence
or VPI, then surgical repair of the palate will be
Hope and Help are on the line.
information within 24 hours 800-24-CLEFT www.Cleftline.org
required. Speech therapy usually alone cannot How can a cleft palate team be located?
correct velopharyngeal incompetence.
The Cleft Palate Foundation can provide you
Feeding/swallowing problems can sometimes with information on cleft palate teams and
be managed through the use of special support groups in your state/region. They also
techniques which the feeding consultant on the provide brochures and fact sheets about
cleft palate team can suggest. various aspects of clefting.
Ear problems should be treated by the child’s For further information on cleft lip and
regular physician or by an ear, nose, and palate, or for a referral to a cleft
throat specialist. Treatment may include the palate/craniofacial team, please contact:
use of antibiotics and/or surgical insertion of
ventilating tubes in the ear drum. Proper Cleft Palate Foundation
management of the child’s ears is essential to 1504 East Franklin Street, Suite 102
ensure good hearing and proper speech Chapel Hill, NC 27514
If the feeding problems and/or chronic middle 919.933.9044
ear disease persist and are related to 919.933.9604 fax
abnormal soft palate muscle function, then firstname.lastname@example.org
surgical treatment of the submucous cleft www.cleftline.org
palate is indicated.
What treatment is available for submucous
For individuals with submucous cleft and
velopharyngeal incompetence, the most
common treatment is surgery. This surgery
involves reconstruction of the abnormal soft
palate. If the submucous cleft causes abnormal
speech, “pharyngeal flap” surgery or
pharyngoplasty may also be recommended. A
primary goal of this surgery is to allow for
normal speech production. This surgery is
done in a hospital under general anesthesia.
Pre- and post-surgical evaluation by members
of a cleft palate team should be part of the
overall treatment program.
In a limited number of cases, velopharyngeal
incompetence associated with a submucous
cleft palate can be treated with an appliance
that fits in the mouth and attaches to the teeth.
This appliance is generally made by a dental
specialist (prosthodontist) associated with a
cleft palate team. Pre- and post-treatment
evaluation by a cleft palate team should be
part of any treatment program.