The association of submucous cleft palate and clefting of the primary palate.

478 records of patients with cleft palate were reviewed to determine the prevalence and significance of submucous cleft palate associated with clefting of the primary palate. The prevalence of submucous cleft palate in the 71 patients with clefts of the primary palate (SMCP-CL) was 13 per cent. This is two to three times greater than the prevalence of isolated submucous cleft palate found in cleft palate clinic patients. Patients with SMCP-CL often had the symptoms of velopharyngeal incompetence (VPI) and middle ear disease. The increased prevalence of SMCP and frequent symptomatology of patients with clefting of the primary palate make it essential that patients with cleft lip have early, thorough evaluation for SMCP. Early detection of SMCP associated with cleft lip and close follow-up permits the prevention of ear problems and the proper management of VPI should it develop.