Cleft palate is a common congenital craniofacial anomaly.
The clinical features of cleft palate are due to an open hole between the nasal cavity and the oral cavity.
A specialized craniofacial team is needed to treat this condition. There are different treatment modalities according to the type and severity of cleft palate. If child has undergone surgery early in life, it will lead to improved hearing. If we wait for the eruption of permanent teeth before correcting the defect surgically, a lesser number of corrective surgeries will be needed later in life.
Cleft palate can be treated by the use of a prosthetic device which can fill the gap in the palate. It can also be treated by the insertion of pins in fourth or fifth month of life. With each passing day, the parents have to tighten the screw so that both the bones can come closer. If the gap is involving the maxilla, a piece of bone can be taken from a rib or the hip of the patient for transplantation.
In order to avoid speech and hearing problems, the patient should be treated as early as possible. Grommets or tympanostomy tubes can be used to aerate the middle ear  . After surgical repair, the problem of speech is usually corrected.
Cleft palate results from the following etiologies.
Cleft palate occurs due to the inability of the palatine processes to meet during development. In incomplete cleft palate, the defect usually involves the soft palate and hard palate is attached to vomer and nasal septum. In incomplete cleft palate, there is usually a disruption in the insertion of muscle fibers. If hard palate is not attached to the nasal septum or vomer, it is referred to as complete cleft palate and both the hard and soft palates are involved. There is a primary palate in front of alveolar foramen and a secondary palate behind it.
Cleft palate can occur in either U form or V form. V form is more common in isolated cases of cleft palate whereas U form is more common in Pierre Robin Sequence.
Cleft palate is a developmental defect in the formation of the palate. It can involve both the soft palate and the hard palate. When both the palates are involved simultaneously, the condition is known as complete cleft palate .
Usually maternal, genetic and family factors play an important role. Air from the mouth escapes into the nose which leads to velopharyngeal inadequacy. Patients usually present with abnormalities in feeding, hearing and speaking. Later on in life, the incidence of psychiatric symptoms such as aggressive behaviour and depression increases. Surgical correction is treatment of choice.
Patients of cleft palate are usually infants and present with feeding problem. On examination there is a hole in the palate. With passage of time patient develops hearing, speech problems and psychiatric symptoms. Surgical repair is the choice of treatment.
Early surgical treatment leads to improved hearing and speech. Prosthetic devices, pins and in severe form, bone from other sites of body may be used to fill the hole.