Additional treatments 

  • perform audiologic follow-up per American Cleft Palate-Craniofacial Association recommendations 
  • amplification therapies, such as hearing aids or auditory training systems, if persistent hearing loss is present
  • insufficient evidence to evaluate electropalatography for treating articulation problems associated with cleft palate

Prognosis 

  • isolated cleft palate, but not isolated cleft lip, may be associated with increased morbidity and mortality 
  • higher palatal arch and wider maxillary tuberosity may each be associated with increased risk for postsurgical hypernasality following cleft palate repair
  • incomplete cleft palate and Hispanic ethnicity each associated with reduced need for second surgery following isolated cleft palate repair
  • may have reduced academic achievement and increased need for special education
  • early growth delay in infants with cleft lip with or without cleft palate may not be associated with long-term effect on growth parameters


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Complications 

  • feeding complications
  • ear disorders
  • speech pathology 
  • dental anomalies
  • obstructive sleep apnea
  • altered facial and dental appearance associated with negative psychological impact in patients with craniofacial anomalies

Prevention

  • periconceptional multivitamin use (including folic acid supplementation) may reduce risk of oral clefts, with greatest risk reduction seen for women starting multivitamin prior to conception. 

Dr Drabkin is a senior clinical writer for DynaMed, a database of comprehensive updated summaries covering more than 3,200 clinical topics, and assistant clinical professor of population medicine at Harvard Medical School.