• Korean Journal of Cleft Lip And Palate
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• v.10 no.1
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• pp.23-32
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• 2007

The classic triad of diagnostic signs of submucosal cleft palate which may be present are: 1) bifid uvula 2) short palate with no muscle in the midline and 3) hard palate with a submucous notching defect in the posterior midline. The treatment of submucous cleft palate are V-Y push back palatorrhaphy, and superior based pharyngoplasty implant in the posterior pharynx. The best speech results were in those children operated upon in the younger age group (especially at or before 2 years of age), thus pointing up the importance of early diagnosis.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.2
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• pp.168-172
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• 1998

Several kinds of surgical methods have been used to treat the submucous cleft palate with hypernasality. The purpose of this study was to evaluate the double opposing Z-plasty which is one of the newly established surgical methods by Dr. Furlow in three cases of submucous cleft palate with hypernasality operated in this department. There were a number of advantage of double opposing Z-plasty. The surgery is adaptable for use in early patient. Midfacial growth retardation and complication were not seen in all cases. Hypernasality was improved subjectively. Using the nasometer, the nasalance score of the postoperative period was compared with that of before surgery, much improvement were noted in 'Ah', 'PaPa'. And fiberoptic endoscope was used to evaluate the velopharyngeal closure pattern. Velopharyngeal closure pattern with velum was improved dramatically, Double opposing Z-plasty seem to be a good procedure for the treatment of submucous cleft palate with hypernasality.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.2
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• pp.180-187
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• 2002

Background and Objectives : The operation Double Opposing Z-Plasty, has been used for improving VPI function in the submucous cleft palate. However, few reports on the effects of the speech change were presented. The purpose of this study is to compare the difference of nasality and nasalance, parents satisfaction between before and after this operation and to consider how much improvement in speech. Materials and Methods : Ten submucous cleft palate children who underwent double opposing Z-plasty were analyzed. We retrospectively studied nasalance, auditory perception (nasality) with hypernasality, patients satisfaction, speech evaluation by using charts review, video tape, telephone interview. Results : In 8 patients of 10 submucous cleft palate, hypernasality reduced and speech intelligibility was higher and mean 0.35 point was increased in the velum length after operation. After operation, nasality was improved (2.0 point) and level of nasal emission decreased. Regarding satisfaction of this operation, scale was mean 2.8 (5 point-scale) : 8 parents were satisfied in the resonance, 3 parents were satisfied articulation. The reason of dissatisfaction was mostly compensatory articulation. Conclusion : To improve of speech in the submucous cleft palate, speech therapy afterthis operation as well as successful surgery should be considered.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.375-380
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• 2005

Furlow palatoplasty has been favored by many plastic surgeons as the primary treatment for the velopharyngeal insufficiency associated with submucous cleft palate. The purpose of this article is to introduce an efficacy of Furlow palatoplasty and speech therapy performed on patients who were diagnosed belatedly as having submucous cleft palates. From 2002 to 2004, four submucous cleft palate patients over 5 years of age with velopharyngeal insufficiency received Furlow palatoplasty. The patients were evaluated through the preoperative perceptual speech assessment, nasometry, and videonasopharyngoscopy. Postoperatively, two patients achieved competent velopharyngeal function in running speech. One of the remaining two could achieve competent velopharyngeal function with visual biofeedback speech therapy and the other could not use her new velopharyngeal function in running speech because of her age. Speech therapy can correct the articulation errors and thus improve the velopharyngeal function to a certain extent by eliminating some compensatory articulations that might have an adverse influence on velopharyngeal function. This study shows that Furlow palatoplasty can successfully correct the velopharyngeal insufficiency in submucous cleft palate patients and speech therapy has a role in reinforcing surgical result. But age is still a restrictive factor even though surgery was well done.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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• pp.81-86
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• 2000

Submucous cleft palate is a relatively uncommon congenital anomaly accompanying velopharyngeal incompetence(VPI). Double opposing Z-plasty has many advantages including prolongation of soft palate, normal midfacial growth, midline scar. We analyzed postoperative results comparing with those of preoperative evaluation by several variables(nasometer, endoscopy, satisfactory scale) in 14 patients treated with double opposing Z-plasty due to submcous cleft palate. Nasalance score in Ah sound, Ma phrase, and Pa phrase decreased 20.23%, 3.25%, and 23.26% in the average, respectively. As a result, hypernasality improved significantly. Closure rate in velum evaluated by endoscopy was increased from 0.44 to 0.76. In objective satisfactory scale checked by each patient's guardian at the postoperative period, much improved in 3, improved in 6, minimally improved in 1, and no difference in 1 was reported. (n=11 patients) Double opposing B-plasty is a good surgical modality in patients accompanying VPI with submucous cleft palate or incomplete cleft palate and will be used more usefully and widely.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.333-335
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• 2009

Congenital palatal fistulas are rare, and few cases have been reported. Most reported cases present with a submucous cleft palate. In terms of etiology, whether the fistula is congenital or acquired has been debated. Moreover, there is not a generally accepted surgical procedure for repair of palatal fistulas. We present a case of a congenital palatal fistula with a submucous cleft palate that was successfully treated with a Furlow double - opposing Z - plasty. We discuss palatal fistulas with a review of the literature.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.54-56
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• 2012

Purpose: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. Methods: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. Results: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. Conclusion: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.

• Archives of Plastic Surgery
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• v.43 no.6
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• pp.582-585
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• 2016

It is uncommon for a palatal fistula to be detected in individuals who have not undergone surgery, and only sporadic cases have been reported. It is even more difficult to find cases of acquired palatal fistula in patients with submucous or incomplete cleft palate. Herein, we present 2 rare cases of this phenomenon. Case 1 was a patient with submucous cleft palate who acquired a palatal fistula after suffering from oral candidiasis at the age of 5 months. Case 2 was a patient with incomplete cleft palate who spontaneously, without trauma or infection, presented with a palatal fistula at the age of 9 months.

• Archives of Craniofacial Surgery
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• v.9 no.2
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• pp.72-76
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• 2008

Purpose: Authors evaluated results of palatoplasty by speech analysis in bilateral, unilateral complete, and unilateral incomplete and submucous cleft palate patients. Methods: The speech outcomes were studied in 15 bilateral, 28 unilateral complete, and 46 unilateral incomplete and submucous cleft palate patients who underwent push-back palatoplasties from January 1998 to July 2004. The patients were divided into 2 groups as 3 to 6, 7 to 10-year-old and compared with 20 normal children(control groups were divided into 10 children on each side). Nasal emission test, hypernasality test, and articulation test were done by speech evaluation table which was composed of 39 different words. Results: In all speech evaluation tests, the group of bilateral cleft palate patients got the worst score. And 7 to 10-year-old groups got better score when compared to the same type cleft palate. Conclusion: Bilateral cleft palate patients have many more speech problems than other patients. In cleft palate patients, the speech problem was improved with ages, postoperatively. And the speech therapy can improve the operative outcomes.

• Proceedings of the KSLP Conference
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• 1998.11a
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• pp.189-189
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• 1998

점막하 구개열(submucous cleft palate)은 특징적인 임상적 해부학적 기형을 나타내는데 이분 구개수(bifid uvula), 근육의 분리(muscular diastasis), 경구개 후연의 절흔(frank notching of the posterior hard palate)등이다. 결국 이러한 기형을 교정하지 않으면 과비음과 공명장애로 인한 조음장애는 사회생활에 중요한 영향을 미치고, 사람의 인상에 나쁜 영향을 주게되어 개인의 인성 형성의 장애와 삶의 질의 저하를 초래하게 된다. (중략)