CLINICAL AND DIAGNOSTIC ASPECTS OF SUBMUCOUS CLEFT PALATE IN THE PRACTICE OF AN OTOLARYNGOLOGIST AND MAXILLOFACIAL SURGEON.



如何引用文章

全文:

详细

Background: Submucous cleft palate (SCP) is an uncommon form of isolated clefts. Its diagnosis is not difficult: a triangular pit due to a bone defect along the midline of the hard palate, a translucent zone of mucosal duplication in the middle part of the soft palate, providing insufficiency of its muscles and nasalization of the voice, a split uvula. In the compensated form of SCP and unclear clinical signs, diagnostic difficulties arise.

Objective: to establish clinical signs-markers of CT and MRI for the diagnosis of SCP.

Materials and methods: The study included patients with SCP treated by the Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan (n=21). All patients underwent CT or MRI.

Results: According to MRI data, a linear hypointense structure is visualized along the midline due to the intermittent position of the levator muscles of the soft palate. According to the CT data, 3 characteristic CT markers of SCP were identified: a triangular defect of the palate on 3D reconstruction of the skull, a defect of the palate in the frontal plane and shortening of the vomer, anterior displacement of the posterior nasal spine and an increase in the nasopharyngeal space in the sagittal projection. Patients begin to seek help in treating upper respiratory tract infections from an otolaryngologist much earlier. According to the data obtained in our study, significant differences were found when assessing the age of detection of SCP by an ENT doctor and other specialists (p = 0.015).

Conclusions: Otolaryngologists can encounter the manifestations and consequences of SCP and suspect the presence of a defect much earlier than other specialists. A promising direction in identifying SCP is the use of radiological diagnostic methods in routine practice. Timely detection of SCP will allow earlier initiation of rehabilitation measures to improve the quality of life and speech.

全文:

受限制的访问

作者简介

Irina Andreeva

Children’s Republican Clinical Hospital

编辑信件的主要联系方式.
Email: arisha.andreeva2008@mail.ru
ORCID iD: 0000-0001-9669-2707
SPIN 代码: 4233-6217

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Kazan

Pavel Tokarev

Children’s Republican Clinical Hospital

Email: facesurg@yandex.ru
ORCID iD: 0000-0003-2439-5492

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Kazan

Damir Marapov

Kazan State Medical Academy, a branch of the Russian Medical Academy of Postgraduate Education

Email: damirov@list.ru
ORCID iD: 0000-0003-2583-0599
SPIN 代码: 5926-0451

M.D., Cand. Sci. (Med.), Assoc. Prof., Depart. of Public Health, Economics and Health Care Management

俄罗斯联邦, Kazan, Russia

Andrey Rudyk

Tatarstan Cancer Center

Email: anru_onco@inbox.ru
ORCID iD: 0000-0002-7309-9043
SPIN 代码: 6578-8613

MD, PhD, oncologist of the Oncological Department № 5 (Head and Neck Cancer)

Kazan, 420029, Russian Federation

Elena Urakova

Казанская государственная медицинская академия — филиал Российской медицинской академии непрерывного профессионального образования

Email: anvu@rambler.ru
ORCID iD: 0000-0003-1140-6412
SPIN 代码: 3629-0860

Roza Ilyina

Kazan State Medical Academy — branch of the Russian Medical Academy of Continuous Professional Education

Email: ilroza@yandex.ru
ORCID iD: 0000-0001-8534-1282
SPIN 代码: 5820-1789

MD, Cand. Sci. (Med.), Assoc. Prof., Depart. of Maxillofacial Surgery and Surgical Stomatology

俄罗斯联邦, Kazan

参考

  1. Leslie E. J., Marazita, M. L. Genetics of cleft lip and cleft palate. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 2013; 163(4):246–258. https://doi.org/10.1002/ajmg.c.31381
  2. Rahimov F, Jugessur A, Murray JC. Genetics of nonsyndromic orofacial clefts. Cleft Palate Craniofac J. 2012; 49:73–91. https://doi.org/10.1597/10-178
  3. Mamedov Ad.A. Vrozhdennaya rasshchelina neba i puti ee ustraneniya. - M.: Detstomizdat, 1998. – 309. (In Russ)
  4. Kharaeva Z. F., Dyshekova F. Kh., Mal’tseva G. S., Azamatova E. K. Immunological aspects of infection in patients with congenital cleft lip and palate. Rossiiskaya otorinolaringologiya. 2022;21(4):82-91. (In Russ)
  5. https://doi.org/10.18692/1810-4800-2022-4-82-91
  6. Stal S, Hicks M. Classic and occult submucous cleft palates: a histopathologic analysis. Cleft Palate Craniofac J. 1998;35:351–358.
  7. Boboshko M.Yu.. Lopotko A. I. Slukhovaya truba – Sankt-Peterburg: Dialog. 2014. – 384 s. (In Russ)
  8. Sharma R.K., Nanda V. Problems of middle ear and hearing in cleft children. Indian J Plast Surg. 2009; Bn. 42 (Suppl. 1):144-148. https://doi.org/10.4103/0970-0358.57198
  9. Bogoroditskaya A.V., Sarafanova M.E., Radtsig E.Y., Prityko A.G. An otorhinolaryngologist's view on the problem of children with submucous cleft palate. Meditsinskiy sovet = Medical Council. 2015;(15):72-75. (In Russ)
  10. https://doi.org/10.21518/2079-701X-2015-15-72-75
  11. Gosain A, Conley S, Marks S, Larson D. Submucous cleft palate: diagnostic methods and outcomes of surgical treatment. Plast Reconstr Surg. 1996;97:1497–1509.
  12. https://doi.org/10.1097/00006534-199606000-00032.
  13. Gosain A, Conley S, Santoro T, Denny A. A prospective evaluation of the prevalence of submucous cleft palate in patients with isolated cleft lip versus controls. Plast Reconstr Surg. 1999;103:1857–1863.
  14. Finkelstein Y., Hauben D. J., Talmi Y. P., Nachmani A., Zohar Y. Occult and overt submucous cleft palate: from peroral examination to nasendoscopy and back again. Int J Pediatr Otorhinolaryngol. 1992 Jan;23(1):25-34.
  15. https://doi.org/10.1016/0165-5876(92)90076-2.
  16. E. Ten Dam, P. van der Heijden, AG Korsten-Meijer, SM Goorhuis-Brouwer, BF van der Laan. Age of diagnosis and evaluation of consequences of submucous cleft palate. Int J Pediatr Otorhinolaryngol. 2013 Jun;77(6):1019-24.
  17. https://doi.org/10.1016/j.ijporl.2013.03.036.
  18. Kuehn D, Ettema S, Goldwasser M, Barkmeier J. Magnetic resonance imaging in the evaluation of occult submucous cleft palate. Cleft Palate Craniofac J. 2001;38:421–431. https://doi.org/10.1597/1545-1569_2001_038_0421_mriite_2.0.co_2.
  19. Ha S, Kuehn D, Cohen M, Alperin N. Magnetic resonance imaging of the levator veli palatini muscle in speakers with repaired cleft palate. Cleft Palate Craniofac J. 2007;44:495–505. https://doi.org/10.1597/06-220.1.
  20. Perry, J. L., Kuehn, D. P., Wachtel, J. M., Bailey, J. S., & Luginbuhl, L. L. Using Magnetic Resonance Imaging for Early Assessment of Submucous Cleft Palate: A Case Report. The Cleft Palate-Craniofacial Journal, 2012; 49(4), 35–41.
  21. https://doi.org/10.1597/10-189
  22. Bae SH, Kim JY, Jeong M, Moon IS, Kim SH, Choi JY, Jung J. High incidence of cleft palate and vomer deformities in patients with Eustachian tube dysfunction. Sci Rep. 2022 Jun 16;12(1):10121. https://doi.org/10.1038/s41598-022-14011-5.
  23. Andreeva IG, Tokarev PV, Marapov DI, Andreev NA. Diagnosis of submucosal cleft palate by an otorhinolaryngologist. Folia Otorhinolaryngologiae et Patholo¬giae Respiratoriae. 2024;30(1):35–41. (In Russ) https://doi.org/10.33848/fopr629561
  24. McWilliams B. Submucous clefts of the palate: how likely are they to be symptomatic? Cleft Palate Craniofac J. 1991;28:247–249.
  25. Yong Lu, Wei Han Congenital Fistula of the Hard Palate With Submucosal Cleft Palate. J Craniofac Surg. 2016 Jul;27(5):1376-7. https://doi.org/10.1097/SCS.0000000000002736.
  26. Evin, Ş. G., Karamese, M., Akdag, O., Selimoglu, M. N., & Tosun, Z. Perforation With Submucosal Cleft Palate in a Previously Undiagnosed Adult Patient. Journal of Craniofacial Surgery. 2016; 27(7), e659–e661.
  27. https://doi.org/10.1097/scs.0000000000003007
  28. Jung SE, Ha S, Koh KS, Oh TS Clinical interventions and speech outcomes for individuals with submucous cleft palate. Arch Plast Surg. 2020 Nov;47(6):542-550. https://doi.org/10.5999/aps.2020.00612.
  29. Bargas, O. Submucosal Cleft Palate. New England Journal of Medicine. 2020;382(22), e77. https://doi.org/10.1056/nejmicm1913924
  30. Stern, Y., Segal, K., & Yaniv, E. Endoscopic adenoidectomy in children with submucosal cleft palate. International Journal of Pediatric Otorhinolaryngology. 2006; 70(11), 1871–1874. https://doi.org/10.1016/j.ijporl.2006.06.013

补充文件

附件文件
动作
1. JATS XML
下载