Cleft Palate Only

Signs and Symptoms

A cleft palate can either be an open and obvious gap in the roof of the mouth or be covered over by the lining or mucous membrane of the roof of the mouth, called a submucous cleft, which is not visible to the naked eye. A submucous cleft is characterized by a wide or split uvula (the small bell-shaped tissue that hangs down in the back of the throat), a small cleft or notch at the end of the hard palate and a thinning of the muscles in the palate that is covered by mucous membrane.

An infant with cleft palate usually needs to be bottle-fed (either breast milk or formula) using special nipples.

Diagnosis

Cleft palate is diagnosed by physical examination at birth, and unlike a cleft lip, a cleft palate is usually not detectable in the womb via ultrasound. Because a submucous cleft palate is not visible to the naked eye, this type of cleft palate may not be identified at birth, but rather be diagnosed later if the child experiences swallowing or speech difficulties.

A genetic evaluation can determine if the cleft is an isolated condition or part of another syndrome or condition. A cleft lip and palate should be diagnosed and treated by an experienced team of experts recognized by the American Cleft Palate-Craniofacial Association, like the Center for Craniofacial Anomalies at UCSF.

Treatment

Surgery is necessary to repair a cleft palate and this intervention is considered reconstructive and not cosmetic.

Since ear infections are more common for a child with a cleft palate, a hearing test is recommended to determine whether ventilating tubes, which reduce the risk of ear infections, should be placed in the ears at the time of surgery. In addition, an eye examination usually is recommended because associated eye anomalies are not uncommon.

The cleft palate is usually repaired when the infant is around 8 to 10 months old or when he or she is starting to make sounds of speech. Palate surgery often takes about two or three hours, with the infant staying in the hospital one or two nights. Although a child's speech usually is normal after cleft palate repair, in some cases, speech therapy or a second palate surgery may be needed. A submucous cleft palate is only repaired surgically if it is determined that the procedure would improve speech difficulties. In addition, orthodontic treatment (braces) will usually be necessary.

A child with a cleft palate may encounter social and emotional challenges unique to this condition. Support organizations and resources are available for children and their families.