Palpation for diagnosis of submucous cleft palate

In patients with cleft palate, either overt or submucous, adenoidectomy is usually contraindicated, since it would tend to worsen hypernasality. Submucous cleft palate, which is shown in the illustration, may be easily overlooked. Bifid uvula, widening and attenuation of the median raphe of the soft palate, and a palpable V-shaped midline notch, rather than a smooth curve, are diagnostic and should be sought.