[Primary "swallowing" function in relation to cleft type after 18 years of interdisciplinary therapy].

The aim of today's interdisciplinary treatment of clefts is complete aesthetic and functional rehabilitation of the patient. But is it possible to also achieve a physiological swallowing pattern?At the Rostock cleft center patients are treated by an interdisciplinary approach from their day of birth until their 18th year of life. Tongue position during swallowing was investigated in 117 consecutive patients. They were assigned to four groups. The control group consisted of 197 age-matched patients receiving non-cleft orthodontic treatment.Patients with clefts of only the primary or only the secondary palate achieved physiological swallowing in 87% or 88% of cases at the age of 18. Of the unilateral CLP cases, 74% also had a physiological swallowing pattern, but in patients with bilateral complete clefts this pattern could be observed in only 46%. In comparison, 95% of non-cleft patients achieved a physiological swallowing pattern following orthodontic and speech treatment at the age of 18. The so-called anterior swallowing pattern was the pathological pattern found most often in cleft and non-cleft patients.In most cleft patients interdisciplinary treatment leads to a physiological swallowing pattern. Only patients with bilateral clefts of lip and palate have a critical prognosis. They need special care and attention.