The "Dynamic Tongue Contraction Technique" for Diagnosis of Soft Palate Cleft in Cases of Cleft Lip and Palate Sequence.

OBJECTIVE

To present and evaluate the dynamic tongue contraction technique as a novel prenatal sonographic method for detecting soft palate clefts in fetuses with a cleft lip and palate (CLP) sequence.

METHODS

This prospective cross-sectional study was conducted at a tertiary care center between September 2023 and September 2024. Seven fetuses with prenatally diagnosed CLP (16-27 weeks' gestation) and 28 control fetuses (14-32 weeks' gestation) underwent 2D ultrasound scans. Three experienced sonographers assessed soft palate integrity using a novel axial-oblique view at the tongue base during fetal tongue contraction.

RESULTS

In all seven CLP cases involving the soft palate, a central gap became visible during tongue contraction, enabling accurate diagnosis. All control fetuses were confirmed to have an intact palate during both rest and dynamic assessment. Postnatal or post-termination confirmation was available for all CLP cases.

CONCLUSION

The dynamic tongue contraction technique offers a reliable and feasible method for evaluating soft palate integrity in fetuses with cleft lip (CL). This functional assessment improves diagnostic accuracy for secondary palate involvement and may complement or enhance current prenatal imaging strategies.