A new study of almost 500 children suggests that hoarseness rare in kids with cleft palate. These kids had undergone palate-repair surgery. Just 5.5 percent of kids with cleft palate in the study group complained of hoarseness – compared with estimates of between 6 and 34 percent of kids without the condition who experience hoarseness, often as a normal result of talking loudly or yelling. Cleft palate happens when tissue in the mouth doesn’t fuse together properly during a baby’s development in the womb, leaving an opening on the roof of its mouth. Heredity plays a role in whether babies are born with cleft palate, as can some environmental factors, such as smoking and alcohol use by the mother during pregnancy. In the study, Otteson and his colleague, Dr. Jacob Robison, examined the charts of 487 kids with a surgically repaired cleft palate who had been seen at a Children’s Hospital of Pittsburgh clinic between 2005 and 2009. Some of those patients had also been treated for cleft lip. Of all the kids, 27 or 5.5 percent – had complained of hoarseness, on average when they were about 4 or 5 years old. The results are published in the Archives of Otolaryngology — Head & Neck Surgery. The findings, the authors say, suggest that kids with cleft palate are no different from their peers with regard to hoarseness and that problems with hoarseness may be under-recognized in the general population. Cleft palate sometimes occurs together with a similar condition called cleft lip, and together they are the most common birth defect. After the initial surgery, however, some kids with cleft palate continue to have problems with hearing or speaking, including hoarseness, and often additional surgeries are needed as kids get older. Hoarseness is a risk, some researchers think, because kids with cleft palate may have to put extra strain on their vocal chords to pronounce some sounds correctly.