Cleft Palate Repair
The objective of cleft palate surgery is to close the palate to restore normal function to eating and drinking and to enhance the development of normal speech.
Clefts of the palate can occur as isolated deformities or in combination with a cleft of the lip. Cleft palates result from failure of fusion of the embryonic facial processes resulting in a fissure through the palate. This may be complete (extending through the hard and soft palates) or any degree of incomplete (partial cleft). The palate forms the roof of the oral cavity and the floor of the nose; thus, a cleft causes a free communication between these two cavities. As a result, treatment of palatal clefts is complex because of potential problems with feeding, speech, middle ear infections, occlusion and jaw alignment.
Surgical treatment of the cleft palate is best accomplished in one surgical procedure before the child reaches 12-14 months of age. The cleft palate is surgically closed by elevating two muscoperiosteal flaps. The levator muscles are elevated, redirected and repaired; and a three-layer closure of nasal mucosa, muscle, and oral mucosa accomplished. Surgery under general anesthesia usually lasts about 2 hours. Special precautions like those after the repair of the cleft lip are necessary for 2-3 weeks. We prefer that the child is weaned from the bottle and pacifier prior to the palatal repair. No hard or crunchy foods are allowed for 3 weeks postoperatively.