Diagnosis and treatment of submucous cleft palate: a review of 108 cases.

The files of 108 patients with submucous cleft palate were reviewed. Special attention was focused on the findings of videonasoendoscopy, videofluoroscopy, and audiometry. Velopharyngeal insufficiency was found in 53 percent of the cases. Since surgical correction is indicated only in the presence of insufficiency, waiting until speech has developed is recommended before considering treatment. A relationship between coronal pattern of velopharyngeal closure and velopharyngeal insufficiency was found. This relationship appears to be caused by the malformation of the musculus uvulae in the submucous clefts. Conductive hearing loss was significantly associated with velopharyngeal insufficiency. This suggests that a velar muscle malformation, which is frequently responsible for the insufficiency in these patients, may also cause Eustachian tube malfunction, resulting in serous otitis with conductive hearing loss.