Anomalies of the cervical spine in the cleft palate patient.

Congenital cervical spine abnormalities are significantly more numerous in patients with cleft palates. In addition to these, the adult with a cleft palate may have cervical spurs associated with degenerative arthritis. Either of these may narrow the spinal canal, so that hyperextension of the neck during endotracheal intubation or while positioning the patient's head for a palatoplasty (or pharyngeal flap operation) may injure the cervical spinal cord. We suggest that radiographs of the cervical spine be obtained in all adults with cleft palate prior to any surgery, and also in such children who have a suggestion of the Klippel-Feil syndrome or other cervical abnormalities. Pharyngeal flap surgery may not be advisable in adult patients with cervical abnormalities.