Bifid Uvula

What is a bifid uvula?

A bifid uvula is a uvula that’s forked or split into two parts. (Your uvula is the fleshy hanging ball in the back of your throat.)

Some healthcare providers call a bifid uvula a “cleft uvula.” That’s because it’s the mildest form of cleft palate — a condition in which your baby’s palate (roof of their mouth) has a split or opening. Like cleft palate, bifid uvula is a congenital condition (birth defect). In other words, people are born with it.

Is it normal to have a split uvula?

A bifid uvula doesn’t necessarily mean there’s something wrong. Some people are just born with a naturally split uvula. However, a bifid uvula can indicate a submucosal cleft palate. That means that your palate didn’t fully develop in the uterus. But unlike a typical cleft palate, you often can’t see a submucosal cleft palate because it’s under the tissue.

Conditions that can cause submucosal cleft palate

A bifid uvula sometimes indicates a submucosal cleft palate. Conditions associated with a submucosal cleft palate include:

• Loeys-Dietz syndrome. The hallmark symptom of this connective tissue disorder is an enlarged aorta (the large blood vessel that moves blood from your heart to the rest of your body).
• Stickler syndrome. People with this hereditary condition may have hearing loss, eye abnormalities, joint issues and distinctive facial features (such as a flattened facial appearance).
• Trisomy. A person with trisomy has three copies of a chromosome instead of two.
• Inflammatory linear verrucous epidermal nevus syndrome (ILVEN). This is a type of skin overgrowth. People with this condition develop wart-like bumps (nevi) that can become itchy, red or inflamed.
• Velocardiofacial syndrome (VCFS). People with VCFS may have varying degrees of cleft palate. They may also have heart defects, speech issues and difficulty feeding. This condition is also called Digeorge syndrome or 22 Q Deletion syndrome.

How rare is a bifid uvula?

Bifid uvulas are common, existing in about 2% of the U.S. population. The condition is more prevalent in certain races, including people of Asian descent and Native Americans. Bifid uvula also occurs more often in babies assigned male at birth (AMAB).

What are the symptoms of a bifid uvula?

The most obvious symptom of a bifid uvula is a uvula that’s split or forked. Your healthcare provider can visualize a bifid uvula during a routine examination. Bifid uvulas aren’t always apparent in newborns right away. This is because the uvula continues to develop over time.

If a bifid uvula is part of a submucous cleft palate, a child may also have other symptoms, including:

• Nasal-sounding speech.
• Feeding difficulties, such as food coming out of their nose.
• Air that leaks out of their nose when speaking.

What causes bifid uvula?

A bifid uvula may be a sign of a submucosal cleft palate. It may also be the result of environmental factors. For instance, smoking, having diabetes and taking certain medications can increase your risk of having a baby with a bifid uvula or cleft palate.

How is bifid uvula diagnosed?

Healthcare providers often diagnose bifid uvula at the time of birth or during a routine pediatrician’s visit. Even if it’s not readily apparent, your provider might suspect bifid uvula or submucosal cleft palate if your baby exhibits other symptoms, like regurgitating their food through their nose.

Do you need to fix a bifid uvula?

Most people with bifid uvula lead normal lives with no treatment. However, if a bifid uvula causes speech or feeding difficulties, your healthcare provider may recommend therapy.

Severe cases that interfere with speech, feeding or quality of life may require surgery.

Can I prevent bifid uvula?

Bifid uvula can be hereditary, meaning it’s passed down through biological families. You can’t always prevent it. However, research shows that you can reduce the risk of having a baby with bifid uvula by avoiding specific environmental factors, like smoking and taking certain medications, and taking prenatal vitamins.

What can I expect if I have a bifid uvula?

Most people with bifid uvulas lead totally normal, healthy lives. But in some people, the condition can cause speech or feeding difficulties. If your baby has complications due to bifid uvula, talk to your healthcare provider about treatment options. They’ll likely recommend speech or feeding therapy — or if necessary, surgery.

When should I see my healthcare provider?

Schedule an appointment with your healthcare provider if you or your baby develop:

• Difficulty swallowing.
• Trouble sleeping.
• Snoring.
• Fatigue or daytime sleepiness.
• Throat irritation.

What questions should I ask my healthcare provider?

Here are some questions you might want to ask your healthcare provider regarding bifid uvula:

• What caused my bifid uvula?
• Will I need to undergo more testing, such as imaging?
• Do I have any other visible abnormalities on my palate?
• Do I have a submucosal cleft palate?
• Will I need treatment?
• Is surgery necessary?

A note from Cleveland Clinic

A bifid uvula is a uvula that’s split or forked. In most cases, people with bifid uvula lead completely normal lives. Sometimes, though, the condition can cause speech or feeding issues in babies. If you or your baby have complications due to bifid uvula, schedule a visit with your healthcare provider. They can determine an appropriate course of action.