CLAPP Classification Scheme and Treatment Algorithm for Submucous Cleft Palate.

Objective: This study aimed to introduce a classification scheme and treatment algorithm for Submucous Cleft Palate (SMCP) to improve surgical outcomes and standardize patient management. Design: A retrospective review of patients presenting with SMCP was conducted, categorizing them according to th...

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Publicado en:Cleft Palate Craniofacial Journal Vol. 63; no. 6; pp. 1431 - 1444
Autores principales: Daiem, Muhammad, Aslam Khalid, Farrukh, Turk, Marvee, Bashir, Muhammad Mustehsan, Azam, Muhammad, Breugem, Corstiaan, Low, David, da Silva Freitas, Renato, Gill, Nauman Ahmad, Fayyaz, Ghulam Qadir
Formato: algorithm pictorial research tables/charts Journal Article
Publicado: Sage Publications Inc. Jun2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2026
      vid: 63
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: CLAPP Classification Scheme and Treatment Algorithm for Submucous Cleft Palate.
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        au:
          Daiem, Muhammad
          Aslam Khalid, Farrukh
          Turk, Marvee
          Bashir, Muhammad Mustehsan
          Azam, Muhammad
          Breugem, Corstiaan
          Low, David
          da Silva Freitas, Renato
          Gill, Nauman Ahmad
          Fayyaz, Ghulam Qadir
        affil: CLAPP Hospital, Lahore, Pakistan
      sug:
        subj:
          Cleft Palate Surgery
          Cleft Palate Classification
          Algorithms
          Patient Care
          Treatment Outcomes
          Pakistan
          Human
          Female
          Male
          Infant
          Child, Preschool
          Child
          Adolescence
          Adult
          Retrospective Design
          Record Review
          Descriptive Statistics
          Zona Pellucida Surgery
          Palatal Muscles Surgery
          Velopharyngeal Insufficiency Surgery
          Postoperative Complications
          Surgical Flaps
          Speech and Language Assessment
          Surgery, Oral
          Hospitals
          Pretest-Posttest Design
          Protocols
          Fistula
          Speech Therapy
          Task Performance and Analysis
          Data Analysis Software
          Pearson's Correlation Coefficient
          Chi Square Test
          Fisher's Exact Test
          Age Factors
          Prospective Studies
          Disease Management
          Infant: 1-23 months
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
          Adult: 19-44 years
          Female
          Male
      ab: Objective: This study aimed to introduce a classification scheme and treatment algorithm for Submucous Cleft Palate (SMCP) to improve surgical outcomes and standardize patient management. Design: A retrospective review of patients presenting with SMCP was conducted, categorizing them according to the proposed classification scheme based on the extent of the zona pellucida and palatal length. Tailored surgical interventions were implemented for each category. Setting: CLAPP Hospital, Lahore, Pakistan, from 2015 to 2023. Patients/Participants: 252 patients with SMCP were identified (M age = 8.29 years; 52.8% male, 47.2% female). Patients with other cleft variants were excluded. Interventions: The classification scheme categorized patients into three types based on the extent of the zona pellucida and further stratified them by palatal length. Surgical interventions included midline incisions, modified and standard Von Langenbeck techniques, and adjunctive palatal lengthening or pharyngeal flaps for patients with inadequate palatal length. Main Outcome Measures: Speech was assessed pre- and post-operatively using a modified Ann Kummer Speech Evaluation Protocol. Post-operative complications, including fistula formation, were recorded. Results: Significant speech improvement was observed, with 89.9% of patients improving from moderate/severe hypernasality to mild hypernasality. Patients receiving a pharyngeal flap exhibited a significant improvement in speech (p <.001) compared to those who did not. Fistulas were observed in 8.7% of cases, consistent with rates reported in the literature. Conclusion: The proposed classification scheme and treatment algorithm show promise in providing a practical framework for SMCP management. This framework will help standardize the management of patients with SMCP and improve postoperative outcomes in these patients.
      pubtype: Academic Journal
      doctype:
        algorithm
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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