Submucous cleft palate: Therapeutic needs at different ages

Decision making about surgery in patients with submucous cleft palate (SMCP) is usually postponed until speech assessment is applicable. Therefore, these patients spend more years with disorders associated with cleft. This study was aimed to investigate and compare the prevalence of different communication disorders in patients with unrepaired SMCP at different ages, since this information can help to provide therapeutic services in multidisciplinary teams.

Clinical records of patients over3 years of age with unrepaired SMCP who were visited in the Isfahan Cleft care team between the years 2005-2015, were reviewed. Percentage of patients demonstrating language disorder, compensatory misarticulation and hypernasality was calculated in three age groups (3-7,7-16, and over than16 years).

The majority of the 61 studied patients were preschool children and 37.8% of them suffered from obvious language deficits. 73.8% of the patients required speech therapy services due to compensatory misarticulation. The prevalence of compensatory misarticulation was significantly different between the group one and two (p=0.008). 37.7% of patients demonstrated moderate/severe hypernasality and so required instrumental assessments.

Considering the high prevalence of language deficits in the studied preschool children, there is an essential need for proper management of probable ear problems and more accurate evaluations of language in this group. The high prevalence of compensatory misarticulation in all studied age groups indicated these patients’ need for coherent speech therapy and psychological services because of the effects on the psychosocial development, also assessments of educational abilities and providing educational support. At least one third of these patients required instrumental assessments and probably surgeries.