Cleft Lip & Cleft Palate Repair

The palate is the roof of your mouth, separating your mouth from the nose. It is made of bone and muscle, and it is covered by a thin, wet skin that forms the red covering inside the mouth.

 

The palate is important for 2 essential activities: speaking and eating. Part of the palate moves back and prevents air from moving through the nose for certain sounds while speaking. If the palate does not function correctly, certain words and sounds can sound very nasal. (Doctors call this velopharyngeal insufficiency or hypernasality). The palate also prevents food and liquids from going up and out of the nose.

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Treatment and Timing of Surgery

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Cleft palate surgery is usually performed when a child is between 8 and 18 months of age. This is when early speech usually starts happening. So, the procedure is done around this time to ensure that your child is physically prepared to start talking.

 

Primarily, surgery is done to close the gap or hole between the roof of the mouth and the nose and reorient the muscles in the soft portion of the palate. The surgeon also makes the palate long enough so it can perform its function properly. Techniques vary between surgeons and the individual case of cleft palate.

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Preoperative Management

 

1. Education—This all starts with a discussion with a trained surgeon. They will help you understand your child’s condition, expectations, and next steps.

2. It takes a highly-skilled, craniofacial team to handle your child’s cleft palate surgery and recovery.
    

• Pediatrician-To optimize and ensure pre and post-operative health.

• Lactation Specialist- To ensure proper nutrition and growth.

• Otolaryngologist-To monitor and treat any hearing dysfunction.

• Oral Surgeon/Dentist-To monitor dental development and jaw growth.

• Speech Pathologist- To maximize post-operative speech development.

• Board Certified Craniofacial Surgeon-To flawlessly complete the surgery.

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Day of Surgery

 

• ​Take a deep breath.

• Your child should not eat or drink 6 hours prior to surgery. You may give water or Pedialyte 4 hours before surgery, but nothing after that point. This will minimize any risks associated with anesthesia.

• Arrive at the hospital 2 hours before your scheduled surgery time.

• The operation typically takes between 2 to 3 hours. 5.  After the surgery, your child will be brought to the recovery room where they will begin a liquid diet.

• In our practice, we recommend one overnight stay. Staying in the hospital for one night reduces parents’ stress; they should not have to worry about managing any acute, post-operative issues. Staying overnight allows the child to be fed by a trained professional, and it also puts a trained staff on hand to handle any post-operative pain management or any other potential issues that could arise.

• The child stays on a liquid diet for 1 week followed by a soft diet for 1 additional week. After these 2 weeks, an age appropriate diet is resumed.

• Bring the child in weekly to see the surgeon for the next 2 to 4 weeks. After that, the child will just need monthly check-ins.