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Craniofacial conditions

Isolated Cleft Palate

Information on diagnosis, feeding, surgery and speech development in isolated cleft palate.

Summary

Isolated cleft palate (Q35) is only visible inside – the lip and jaw are intact. It is often not detected before birth and is diagnosed after birth by clinical inspection. Babies cannot generate suction; special bottles nonetheless allow breast milk to be given. Palate closure usually takes place between 9 and 18 months.

Definition & specifics

Basics

Definition & specifics

In isolated cleft palate (ICD-10 Q35) only the palate is cleft – lip and jaw are intact and outwardly unremarkable. The condition is therefore not visible externally and is often missed on ultrasound.[1]

Submucous cleft palate

A special form is the submucous cleft palate: the mucosa is intact, but the underlying muscle and/or bone are not fully united. Typical signs: split uvula (bifid uvula), notch in the midline of the soft palate, submucous bone deficiency of the hard palate. It is often diagnosed only through speech abnormalities in toddler or school age.

Diagnostic challenge Isolated cleft palate is barely detectable before birth. After birth the palate must be actively inspected and palpated – this is part of newborn screening. A submucous cleft can remain undetected without targeted inspection.

Feeding & first symptoms

Feeding

Feeding difficulties after birth

Babies with cleft palate cannot build up sufficient negative pressure in the mouth. Breastfeeding is usually not possible; breast milk can however be pumped and given with specialised bottles (Medela SpecialNeeds, Pigeon, Mead Johnson Cleft Palate Nurser). → nutrition page

Treatment

Surgery

Surgical palate closure

9–18 months
Palatoplasty. Closure of soft and hard palate; timing balances speech development vs jaw growth.[2]
After surgery
Regular speech checks. Velopharyngeal insufficiency (VPI) occurs in some children even after good closure. → speech therapy
As needed
Velopharyngoplasty. Surgical correction of VPI when speech therapy alone is insufficient.

References

  1. Maarse W et al. (2011). Diagnostic accuracy of ultrasound in detecting prenatal cleft lip and palate. Ultrasound Obstet Gynecol, 37(5):495–500. DOI
  2. Grunwell JR et al. (2021). Timing of palate repair and speech outcomes. J Craniofac Surg, 32(3):846–51. DOI
Related topics

Related topics

Further pages on this condition – diagnostics, treatment, cross-cutting topics and research.

Related conditions
Cleft Lip & PalatePierre Robin Sequence
Treatment & surgery
Treatment pathwaysAlveolar Bone GraftComplications · cleft
Cross-cutting topics
Hearing & earsSpeech Therapy & Language DevelopmentSleep & breathing
Research & sources
ResearchCraniofacial library
Further information

Further information

Selected authoritative external sources on this condition.

External third-party sites; linked, not hosted. Not a recommendation in individual cases; does not replace medical advice.

Note: The content on this page is provided for general information and does not replace individual medical advice, diagnosis or treatment. Information on insurance coverage is non-binding; the case-by-case assessment by the responsible insurer is decisive. Please consult your care team if you have any questions.