34. Cleft palate-risks in subsequent sibling
Parents unaffected- 4%
Affected relative- 7%
Affected parent- 15%

35. Cleft palate – associated problems
During speech and swallowing, palate moves superiorly and posteriorly against posterior pharyngeal wall, shutting off oropharynx from nasopharynx [velopharyngeal closure]
Allows increase in intraoral pressure for release with certain sounds in speech
A cleft palate allows air to escape via nose- hypernasal speech

36. The affected infant cannot generate effective intraoral pressure-ineffective sucking and feeding problems
Abnormal insertion of palatal muscles- ineffective opening of auditory tube- increased incidence of otitis media
Recurrent otitis media-hearing loss