Background: Submucous cleft palate (SMCP) is a unique type of cleft palate. Delayed diagnosis is frequently associated with suboptimal speech outcomes. Early detection of SMCP has thus emerged as a key priority in mitigating this challenge.
Objective: This study aims to identify early diagnostic indicators of SMCP by analysing the association between chief complaints and age, along with early symptoms reported by caregivers before the onset of speech problems.
Patients and methods: Medical records of 278 consecutive SMCP outpatients were retrospectively reviewed between January 1, 2013 and September 30, 2023. Three clinical manifestations related to SMCP were identified in medical records: speech problems, abnormal palatal morphology, and feeding difficulties. Descriptive statistical analyses were performed to evaluate the distribution of chief complaints across different age groups and the percentage of feeding difficulties and abnormal palatal morphology in the subgroup with speech problems as the chief complaint.
Results: Regarding the chief complaint, speech problem was the most common chief complaint for consultation (183 patients, 65.8%), followed by abnormal palatal morphology (88 patients, 31.7%), and 7 (2.5%) patients reporting feeding difficulties as the chief complaint. Abnormal palatal morphology emerged as the most common chief complaint in patients younger than 2 years (47 patients, 92.2%). In contrast, the number of patients reporting speech problems as the chief complaint increased significantly in patients older than 2 years (183 patients, 80.6%).
Conclusion: Speech problem was identified as the most frequent reason for consultation among patients with SMCP. Feeding difficulties, including nasal regurgitation, were among the earlier diagnostic indicators for SMCP.
Keywords: Bifid uvula; feeding difficulty; palatal bony defect; speech problem; submucous cleft palate.
Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of Mutaz B. Habal, MD.