Cleft/Lift Palate and Craniofacial Surgery

Cleft palate can form on one or both sides of the mouth roof and it can stretch to the full length of the palate.

• The first surgery to repair cleft palate is typically done between 6 and 12 months of the child’s age.
• Depending on the extent of the deformity, multiple surgeries are usually necessary over the course of 18 years.
• The first surgery provides functional palate, helps the proper development of facial bones and teeth and reduces the likelihood of fluid developing in the middle ears.

Procedure Info

For both cleft lip and cleft palate surgeries the child is under general anesthesia, asleep and not feeling any pain. When repairing cleft lip, an oral and maxillofacial surgeon trims the tissues and sews the lip together. The goal is to make the stitches as small as possible, so the scar is barely visible once the stitches absorb into the tissue as the scar heals. When repairing cleft palate, the surgeon usually moves the tissue from the mouth roof to cover the soft palate. This surgery is typically performed between 9 and 12 months of age to prevent speech problems as the child develops. In some cases ear tube surgery, which involves placing small cylinders in the ear drum to avoid fluid buildup, is also necessary.

Some additional procedures and surgeries might be recommended for complications caused by cleft lip and cleft palate, including:

• Rhinoplasty (nose surgery)
• Bone growth surgery (the connection between the mouth and nose)
• Hearing aids
• Speech therapy
• Psychotherapy to help the child deal with stress

Pre-surgery

If your child is born with cleft lip, cleft palate or the combination of both, the best way to start is to find a speech or feeding therapist right after the birth. The child must be healthy and have proper weight before the surgery and feeding therapist will help you feed your child in the most effective way.

The surgeon will perform a thorough physical examination of the child, review its complete medical history and take blood samples to check the blood type and do complete blood count. He will also ask about any medications your child takes, including over-the-counter vitamins and herbs.

You will be asked to stop giving your child any anti-clotting medications about a week before the surgery, including warfarin, ibuprofen, aspirin and others. On the day of the surgery the surgeon will make sure that your child is in perfect health to undergo the procedure and if there’s a problem, the procedure might be postponed. Several hours before the surgery your child won’t be able to eat or drink anything other than a sip of water and the medication necessary for the procedure.

Post-surgery

The approximate time spent in the hospital after the surgery is 5-7 days, and the recovery might take up to 1 month. You will be shown how to take care of the wound throughout the recovery period, how to keep it clean and moist with ointment.

Most children don’t have any problems during the recovery period, but they must be on a liquid diet and potentially wear arm cuffs or splints so as not to touch the wound.

Potential problems that need to be solved after the surgery:

• Another surgery to repair the scar
• Teeth correcting procedure
• Hearing issues
• Muscular problems in the palate and subsequent problems with speech

Possible Risks

Cleft lip and cleft palate surgery will improve the child’s overall quality of life, appearance and the ability to speak, eat and breathe. Just as with any other surgical procedure, though, there are some potential risks:

• Bleeding
• Infection
• Poor healing
• Damage to blood vessels and nerves