Impact of anatomical abnormalities on velopharyngeal insufficiency in patients with submucous cleft palate

Abstract

BackgroundSubmucous cleft palate (SMCP) is a congenital anomaly characterized by Calnan's triad. However, in clinical practice, it is common forindividuals to exhibit one or two anatomical abnormalities within the triad. Furthermore, the definition of SMCP has been diverse and ambiguous in previous studies. Therefore, this study aimed to analyze the correlation between anatomical abnormalities and development of velopharyngeal insufficiency (VPI). MethodsWe conducted a retrospective analysis of 99 patients referred to our clinic for speech issues or anatomical abnormalities identified during routine oral examinations from January 2012 to June 2023. A single surgeon performed all physical examinations. We evaluated the presence of a bony notch, zona pellucida, and bifid uvula, assigning a score to each, and analyzed their correlation with VPI. The correlation with each of the abnormalities for VPI was examined, along with the relationship between the number of abnormalities and VPI. ResultsOf the 99 patients, 27 were diagnosed with VPI. Only the bony notch had a significant correlation with the development of VPI. The incidence of VPI tended to increase with the presence of more anatomical abnormalities. VPI occurred in approximately 40% of patients exhibiting all three anatomical abnormalities. ConclusionThe study findings highlight the importance of meticulous intraoral examinations in SMCP patients and careful monitoring in patients with a bony notch or two or more anatomical abnormalities.