Surgical treatment of the cleft palate is best accomplished in one surgical procedure. This will have best results if the procedure is carried out before the child reaches 12-14 months of age. The muscoperiosteal flaps are raised and the cleft palate is then surgically closed. The levator muscles are also elevated, redirected and repaired. The nasal mucosa, muscle and oral mucosa are closed. This surgery is usually done under a general anesthetic and will last for up to 2 hours. There are certain precautions that should be taken after the of the cleft palate surgery repair. Hard or crunchy food should be avoided for at least a minimum of 3 weeks.
In a lot of cases, cleft palate surgery is carried out when the child is older,this can fall between 9 months and 1 year. This time scale allows the palate to change as the child grows. Carrying out the cleft palate surgery when the child is this age will also help prevent further speech problems as the child develops.
Cleft Palate Surgery – The Procedure
In cleft palate surgery, your child will have general anesthesia (totally asleep and not feeling pain). Tissue is then taken from the roof of the mouth and may be moved across to cover the soft palate. Sometimes different children will need more than 1 surgery to completely close the palate. During these cleft palate surgey procedures, the surgeon may also need to carry out rhinoplasty.
Most of cleft palate surgery patients will develop what is known as velopharyngeal competence after palate closure, and may require a certain amount of speech therapy and/or an additional surgical operation called a pharyngeal flap. This procedure involves raising a flap of tissue from the posterior pharynx and inserting it into the soft palate. This flap is indicated when the repaired palate is too short or the muscles will not function properly, this then causes a persistent hypernasal speech. This operation is usually carried out after the age of 4-5 years when the childs speech and velopharyngeal competence can be thoroughly assessed and before the child begins school.
Cleft Palate Surgery and Other Defects
A cleft palate causes defect can sometimes involve the teeth and gums. And a child with a cleft palate may probabaly need cleft palate surgeryafter the initial cleft palate has been repaired, allowing the replacement of the missing bone in the gumline. The “alveolus” is the bony part of the gumline which can be found in the region of the upper jaw and lower jaw that contain the teeth. The placement of bone to this area is known as “alveolar cleft bone grafting” (ACBG).
The cleft palate surgery is done in the operating room under general anesthesia so that the child will sleep throughout the entire procedure.
Cleft Palate Surgery – Hospital Stay
The average hospital stay is somewhere around 5 to 7 days. A Complete recovery may take anything up to 4 weeks. Some children will then continue to have speech defects after the cleft palate surgery because of muscle problems in the palate. Speech therapy is then required.
Late Cleft palate Surgery – Treatment
The Craniofacial Center can also help with those individuals that have grown up without any kind of access to a, coordinated well designed team approach. For many adults with these speech problems, the previously mentioned pharyngeal flap, in conjunction with an intensive regimen of speech therapy, can produce very significant improvements. Orthognatic surgery is widely available to patients with certain deformities of the jaw. This can in turn improve their appearance as well as to correct the dental occlusion.
For the soft tissue revision of a severely tightened or notched upper lip, an Abbe flap is the probabaly the surgical option. This procedure is usually indicated in bilateral cleft patients who have a short or deficient columella and a tightened upper lip. This procedure can add a fullness to the upper lip as well as add lenght to the columella.
There are also a number of additional surgical therapies and cleft palate surgery, very similar to the ones described here, and are available to patients who desire further improvements.
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