What is Bifid Uvula?
A Bifid Uvula is a pathological condition in which there is a division or a split in the uvula. The uvula is a tissue that dangles from the roof of the mouth at the end of the soft palate. This condition is normally identified at the time of the birth during routine examination of the baby. There are rare cases in which it can be identified on ultrasound conducted before the birth of the baby.
Bifid Uvula does not cause any health concern for the baby and is normally an incidental finding. However, there are certain situations where Bifid Uvula is an indicator for a submucous cleft palate. This occurs when there is a split in the palate under the membrane of tissue that covers the roof of the mouth. A submucous cleft palate may be difficult to visualize since it is covered by the mucous layer.
Even though, many experts believe about the relationship between Bifid Uvula and submucous cleft palate but there is no concrete evidence of this relationship. The primary reason for many to believe this relationship is the definition of submucous cleft palate which has the mention of Bifid Uvula in it. However, recent studies have come up with more subtle manifestations of submucous cleft palate and it has been observed that this condition can exist even without Bifid Uvula. This is what puts the relationship between the conditions in question.
What Causes Bifid Uvula?
Coming to the causes of Bifid Uvula, there are various factors including environmental, genetic, and toxic that may cause development of Bifid Uvula. However, there is no definite cause identified as of yet. If the cause is genetic, then the likelihood of a child getting Bifid Uvula will depend on the number of family members affected by it and whether they are direct relatives of the child or not.
Bifid Uvula normally occurs in the second trimester of pregnancy between the 7 and the 12 weeks. It occurs as a result of an abnormality in the fusion of the uvula. It has been observed that females who smoke during pregnancy are more at risk for delivering a child with Bifid Uvula. Additionally, females who have a history of substance abuse can also deliver a child with Bifid Uvula. Females with diabetes or epilepsy at times can also have a child with this condition.
What are the Complications of Bifid Uvula?
Bifid Uvula in itself causes no complications as such. However, when it occurs with submucous cleft palate then it may lead to certain complications. These complications include:
Speech Difficulties: A submucous cleft palate causes the child to have a nasal tone to the speech. In these instances, submucous cleft palate may not be evident until the child actually starts speaking.
Swallowing Problems: Some children with Bifid Uvula along with submucous cleft palate may have problems with swallowing. This is basically due to inadequate muscular tissues resulting in regurgitation. This may be observed immediately after birth when the baby will have a weak suck response and will take a long time to feed. The milk may also come out of the nose during feeding. Other than this, there are no obvious complications from Bifid Uvula.
How is Bifid Uvula Treated?
Bifid Uvula is an absolutely benign condition and does not require any specific treatment. However, if a child is born with Bifid Uvula then it becomes necessary for the child to be evaluated for submucous cleft palate. If it is present, then close monitoring of the condition is necessary and if required treatment may be needed in the future.
In cases of submucous cleft palate, sometimes surgery may be required to correct the condition. Abnormal speech is the only symptom for which treatment will be required. The treatment will aim at decreasing nasal quality of the speech. Treatment will include watchful waiting and only if there are observable problems with speech will treatment in the form therapy or in rare cases surgery.
Some people with submucous cleft palate have a condition called velopharyngeal insufficiency. This causes the individual to have speech problems. This is a condition in which surgery will be required to correct the problem. If the parents of the child are averse to having surgery then they can consult a dentist who can fit in special devices in the mouth to improve the quality of speech.
Some children with Bifid Uvula and submucous cleft palate tend to have frequent buildup of fluid in the ears with infections. This at times can affect the hearing of the child. These problems again need to be addressed by an ENT specialist with administration of antibiotics to clear the infection or inserting tubes in the eardrum to improve hearing and drain the fluid. These are conditions that need to be addressed promptly as delay in treatment can cause permanent heart problems.
In conclusion, Bifid Uvula by itself is an absolutely benign condition and causes no complications or health problems. However, when it occurs in combination with submucous cleft palate it may result in problems with feeding and speaking. Some children also have hearing problems as well. If a child has Bifid Uvula at birth then assessment for a submucous cleft palate should be done and regular monitoring should be done.[1,2]
In case if the child has problems with speech then treatment with a speech therapist is recommended. Treatment for hearing and feeding problems should also be treated accordingly. Other than this, there is nothing to worry about for children with Bifid Uvula.[1,2]
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