[The effect of the presence of a submucosal cleft palate on the middle ear and speech].

Abstract

Introduction: Hidden or submucosal cleft palate (SCP) is a rare form of isolated cleft that is characterized by rhinolalia in the presence of an apparently intact palate.

Objective: To analyze the age of detection of SCP in children and evaluate the impact of its presence on the middle ear and speech development of patients.

Material and methods: 17 patients with SCP were examined and treated in the departments of otorhinolaryngology and maxillofacial surgery of the Children's Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan. The duration of observation of patients ranged from 1 to 4 years.

Results: The median (Me) age of diagnosis of SCP was 7.18±3.83 years (95% CI 5.21-9.14), of which in 10 patients (58.8%) SCP was first suspected by an otorhinolaryngologist. When analyzing the age of detection of SCP depending on the detection of otitis media with effusion (OME) and epitympanitis, we established statistically significant differences (p=0.007; p=0.043, respectively). When assessing the dependence of the probability of OME on the age of detection of SCP using ROC analysis, an ROC curve was obtained that characterizes the dependence of the probability of OME on the age of detection of SCP. The resulting model was statistically significant for OME (p=0.011). When analyzing the comparison of the age of detection of SCP depending on the presence of speech delay, statistically significant differences were established (p=0.029).

Conclusions: The analyzed data from patients with SCP indicate serious changes in the middle ear: from OME to the presence of cholesteatoma. The presence of SCP affects not only the clarity of spoken speech, but also contributes to its delay. The data obtained demonstrate a direct relationship between the severity of manifestations in the middle ear and the age at which the diagnosis of SCP was made by an otorhinolaryngologist.