Abstract:

Submucosal cleft palate (SMCP) is a special type of cleft palate. Velopharyngeal insufficiency (VPI) such as hypernasal speech and nasal emission occurs in some patients, but about 30%-50% of patients do not show any speech symptoms of VPI and do not need surgical treatment. Patients with SMCP do not have the typical Calnan triad, and their clefts have different morphological classifications and show different velopharyngeal closure rates. The surgery indications and surgical design for SMCP are controversial. Some scholars believed surgery should be determined based on the patients specific velopharyngeal function, whereas other scholars believed that surgery should be performed as early as possible. On the basis of literature review and clinical observation of SMCP for the past 10 years, this study analyzed the different types of SMCP and evaluations of velopharyngeal function, surgical indications, and speech therapy. To avoid excessive medical treatment and delayed surgery, we present the following suggestions for the timing of speech evaluation and surgical treatment of SMCP. First, surgery is only suitable for SMCP patients with VPI. Second, preoperative speech evaluation is required. Third, the appropriate operation time should not be earlier than 2 years old, considering that effective speech assessment can usually be performed around 2 years old in accordance with the rules of children’s speech and language development.

Key words: submucosal cleft palate, velopharyngeal faction, cleft palate speech