Potential for ultrasound in occult submucous cleft palate

Very limited research has been done on the application of ultrasound to evaluate the palate postnatally. However, technological advancement of endoscopic US technology has made it integral during the assessment of loco-regional cancers of the gastrointestinal tract. Endoscopic US could be used to visualise and evaluate the musculature of the soft palate to identify submucous cleft palate. Indeed, the MTurbo® US system (Sonosite Inc., Bothell, WA, USA) has been used to evaluate the palate of three children with submucous cleft palate, thus identifying the absence of the central uvularis muscle and discontinuation of the levator sling in each of the submucous cleft palate cases, findings that were confirmed during palatoplasty [5]. Calnan’s triad is more than half a century old and provides a sensitivity of only 50%, yet it remains the mainstay of submucous cleft palate diagnosis. Research into using US to identify children at risk of submucous cleft palate could make detection of occult submucous cleft palate possible earlier. The question of whether endoscopic US could succeed in this task is one that should be explored.