Surgical Treatment for Cleft Palate
A cleft palate is usually repaired between 11 and 13 months of age. The plastic surgeon carefully puts the tissue and muscles in a better position so that the opening between the nose and mouth is closed and the roof of the mouth is rebuilt. Incisions are made on both sides of the opening, and specialized flap techniques are used to reposition the muscles and the palate. The repair is then stitched closed, usually in the middle of the roof of the mouth, so that normal feeding and speech development can occur and growth can continue throughout the child’s life. Surgery for cleft palate is performed under general anesthesia. Children are observed overnight in the hospital and remain there until they are comfortable and can drink sufficient fluids. Most children are eating and drinking comfortably after the first night and are discharged home at that time.
The goal of surgery is to create a palate that works well for feeding and speech. Most children will have good speech after palate repair. If there is breakdown in the palate that does not heal in the first two months after surgery, this is called a fistula. If the fistula is felt to result in nasal leakage of air or fluids, then a fistula repair would be performed after at least six months following palate repair to be certain the tissues have adequately healed to withstand repair. Some children, however, may need further surgery on the muscles of the palate or the muscles of the throat to achieve normal speech.
What to Expect After Cleft Palate Surgery
In partnership with baby’s speech therapist, caregivers will be well prepared for cleft palate surgery. Since the baby will not be able to put any objects into their mouth after the surgery, a speech therapist will offer parents techniques and resources for feeding, such as open cup feeding, starting between six to eight months of age.
Parents can expect that baby will stay overnight after their surgery to monitor feeding and pain control after the procedure. Usually, patients are sent home with elbow immobilizers to keep baby from putting their hands or objects into their mouth for at least four weeks after the procedure.