The Role of Reconstructive Surgery in the Correction of Cleft Palate

What is Cleft Palate?

Cleft palate is one of the most common facial birth defects in children from all over the world and occurs in approximately one of every 700 births. During the first trimester of pregnancy, the fetus develops all major facial components. When the roof of the mouth fails to form completely, a gap is left where tissue should be. The condition may be mild to severe and may affect one or both sides of the mouth.

The Importance of Repairing a Cleft Palate in Young Children

The American Academy of Pediatrics states that every baby should be provided with an ample amount of breast milk or reconstituted infant formula for the first six months of life. Unfortunately, feeding a newborn with cleft palate is immensely difficult, especially when the condition is severe. In order to ensure that the affected child is able to eat an adequate amount during this period, it is important that the cleft in the palate be repaired as soon as is possible.

What Can Be Done to Correct a Cleft Palate?

A team of maxillofacial surgeons and other specialists work together to assess the extent of the condition before a plan for reconstructive surgery is developed. In addition to improving the appearance of the nose and mouth area, the primary goals of this complex form of surgery are to enhance the child’s ability to eat, speak, breathe and hear normally. Dental restoration may be necessary in the years following surgery to ensure that the formation of teeth is not affected by the original procedure.

The team of medical professionals that collaborate on the reconstructive procedures and rehabilitation include:

Oral and maxillofacial surgeon

  • Cosmetic surgeon
  • Pediatrician
  • Speech therapist
  • Orthodontist
  • Auditory specialist
  • Ear, nose and throat doctor
  • Counselor or therapist to help with emotional issues

Treatment Before and After Reconstructive Surgery of a Cleft Palate

Prior to the surgical correction of the cleft, an orthodontist may recommend the use of a custom orthopedic device. The device usually resembles a retainer and is fitted into the roof of the child’s mouth. Its purpose is to gently and gradually bring the two sides of the palate closer together, which will enable the surgeon to perform the reconstruction more efficiently.

If a cleft lip is also present, this condition is generally repaired first. The entire procedure usually takes a few hours and is followed by a recovery period of about two days in the hospital. After the lip has healed sufficiently, the surgeons can begin work on the cleft in the palate. Follow-up procedures with an orthodontist, oral and maxillofacial surgeon and speech therapist may continue into late childhood, depending on the severity of the cleft. After a period of six months to two years, the child should enjoy a relatively normal pattern of speech and functionality of the entire mouth.

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