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Cleft Lip and Palate: Cleft Palate Only

Cleft palate only involves only the roof of the mouth – the hard and/or soft palate. As with cleft lip conditions, its extent is variable. A divided palate creates feeding, breathing and speech development concerns. Cleft-palate-only conditions have significantly less impact on dental and nasal development, compared to cleft lip/palate cases. Below are the major categories involving cleft palate only.

Hard cleft palate only

Hard cleft palate only involves only the part of the roof of the mouth that is bony and hard.

Soft cleft palate only

Soft cleft palate only involves only the part of the roof of the mouth that is soft, rather than bony and hard. The soft palate is located at the back of the mouth, near the throat.

Extended midline cleft palate

Extended midline cleft palate occurs when the cleft extends from the hard palate through the soft palate, making things a bit more complex than when only the hard palate is affected. When the division goes through both palates, sometimes additional surgery is required to ensure that the length of the soft palate is enough for speech production, but not so much that it causes difficulty in swallowing and breathing. The vast majority of children (more than 90 percent) require only one surgery to both close the palate and achieve normal speech.

Submucous cleft palate

Submucous cleft palate is one that is "hidden" beneath the lining of the roof of the mouth. The lining (mucous membrane) may make it difficult to identify the cleft, as it is not visible, but detectable by careful manual examination. This type of cleft may appear in the soft palate and be lacking in muscular tissue, with the area's muscles pulling perpendicular to their normal positions.

Hard palate submucous clefts are located in the middle bony area of the roof of the mouth. Sometimes, this type of cleft may be identified by gently feeling for a notch or depression in the roof of the baby's mouth. Occasionally, these clefts include a cleft uvula (the tissue that hangs down at the back of the throat). As with the other cleft-only conditions, this kind can significantly affect speech, lead to middle ear problems, and make it difficult to eat/swallow. However, some patients do not experience these difficulties.