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Treatment - Palate |
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Cleft Palate Surgery |
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The cleft palate repair is performed at 10 months of age. The cleft hard palate should be closed as early as possible, as an open cleft is detrimental to normal speech development. The hard palate is supported by bony shelves with mucosal covering. The tissue of the palate is detached and rearranged to close the cleft. The muscles of the soft palate are also repositioned to allow for the best possible function for speech. The primary goal of repairing the palate is to achieve acceptable speech. Occasionally, this means that more than one surgical procedure may be needed to completely close the opening in the roof of the mouth. Even after the opening is completely closed, an additional surgical procedure may be needed to make the palate longer and more mobile so that your child has mechanism to achieve normal speech In doing so an area of bone is left open at the sides and this area is healed by cells from the edge of the mucosa and the sheet covering the bone.
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Post Operative Care |
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After repair, the surgical site will be swollen and bruised. The stitches used will either dissolve or be removed a few days after surgery. Instructions regarding feeding your child and caring for the repaired area during this period will be given. Arm restraints that keep your child’s elbow from bending will be prescribed to prevent him/her from putting fingers or objects near the repair. The scar on the lip usually looks red after surgery. It may get firmer and tighter during the first few weeks after surgery. Although it will gradually fade, the scar will not completely disappear.
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Surgical Correction Of Palate |
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Cleft palate should be repaired within 6months.At the age of 7 months thee child starts to speak. Cleft in thee palate causes disturbed speech .so surgeons insist on doing surgical correction before 6 months. In cleft palate cases the malfunction of the Eustachian tube (tube connecting the ear and the throat) is corrected along with the palatal repair in order to avoid ENT (Ear, Nose and Throat) problems as middle ear problems and hearing difficulties are likely to occur to many children born with the cleft.
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There are two types of palate |
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- Hard palate: supported by bony shelves and covered by soft tissue
- Soft plate: consist of muscle and soft tissue
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Early repair is under taken to make the control of food in the mouth easier, to keep it out of nose, and to the child normal anatomy, by the time it starts experimenting with sounds at three to six months of age. When the palate is repaired the aim is to close the gap in the roof of the mouth, to repair the muscle in the soft palate and lengthen the muscular part, speech and voice quality carefully |
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Surgical Correction of the Soft Palate: |
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The muscle of the soft palate and pharynx participate in various tasks such as blowing, sucking, swallowing, and speaking. A baby with an unrepaired cleft may not make the same sound as a baby with the palate intact. To correct this, the second operation on the palate known as Pharyngoplasty is carried out. Pharyngoplasty is an operation that narrows the space at the back of the throat and helps to reduce air escaping through the nose and Hypernasality (nasal speech).
The purpose of the various surgical modifications at the junction of the hard and soft palate cleft is to minimize the chance of the formation of an oronasal fistula at this junction. |
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Muscles of the Palate |
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- Muscle connecting uvula
- Muscle connecting throat and palate
- Muscle elevating the palate
- Muscle connecting soft palate and uvula, which helps during speech, this muscle is mobile during speech. Tension suture is done in the soft palate to harden it. This helps to position the Eustachian tube properly and the secretion is drained into the throat.
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