Curriculum · Pediatric / Nutrition & Growth / EPI / Routine Child Examination
Cleft palate
What it is
Cleft palate is one of the congenital anomalies. By mechanism it is a malformation, that is an abnormal development of the organ or tissue that is abnormal from the beginning, before 10 weeks of gestation; the examples given beside it are anencephaly, agenesis of a limb and VSD.
By weight it is a major anomaly: major anomalies interfere with the normal functioning of an individual and pose a significant health problem or risk to life, and cleft palate is listed with CHD, NTD and omphalocele. Minor anomalies do not interfere with normal functioning and are usually only of cosmetic significance, such as a simian crease, an accessory nipple, clinodactyly or a preauricular tag. Major anomalies are present in 2-3% and minor anomalies in around 15% of live births.
What can go wrong
Two problems follow a cleft palate: a feeding problem, and recurrent infection.
The route to that infection runs through the eustachian tube. Cleft palate is one of the causes of mechanical obstruction of the eustachian tube, and obstruction of the tube means lack of ventilation and drainage of the middle ear, then resorption of the air with negative middle ear pressure, then accumulation of middle ear secretions and bacterial superinfection, which is acute otitis media.