Cleft Palate Surgery, 2 Times Failed – Re-surgery Successful

Cleft Palate Surgery, 2 Times Failed – Re-surgery Successful

World-renowned surgeon for cleft lip and palate repair

Dr. SM Balaji is a world renowned expert on cleft lip and palate surgical correction. He has over 30 years of experience operating on cleft cases. Many cases of cleft repair done elsewhere, which have failed are often referred to him. His many innovations to existing cleft surgical procedures have to lead to better results. These have become standard operating protocols worldwide.

Young boy with two failed cleft repair surgeries elsewhere

This is a case of a young boy who had undergone cleft surgeries twice elsewhere. Both surgeries had not resulted in closure of the cleft. This had been a cause of anguish to his parents as his food intake was very impaired by the cleft. They had been searching for a long time for a cleft surgeon who could repair their son’s cleft. This search for the best cleft surgeon led them to Dr. SM Balaji.

The treatment plan explained in detail to parents

The patient was first examined and the treatment plan was explained to the parents. The parents agreed to the surgery.

Veau-Wardill-Kilner technique with Orticochea pharyngoplasty

General anesthesia was first administered. The Veau-Wardill-Kilner palatal pushback technique and Orticochea pharyngoplasty were then performed. This resulted in complete closure of the cleft defect. A positive suction test was then demonstrated at the end of the surgery. This would ensure proper speech for the patient.

The patient’s parents presented to Dr SM Balaji six months post-surgery for a checkup. The cleft remained closed and the patient’s speech was much improved. His parents expressed their extreme gratitude.

Surgery Video


Cleft Palate – Velopharyngeal Incompetence – Hypernasality Speech Correction Surgery – Pharyngoplasty

Cleft Palate – Velopharyngeal Incompetence – Hypernasality Speech Correction Surgery – Pharyngoplasty

A patient with velopharyngeal insufficiency presents to Dr SM Balaji

The patient had been born with a cleft lip and palate. This had been set right as an infant. She later developed velopharyngeal incompetence. This is where there is escape of air through the nose during speech. It also manifested as difficulty pronouncing certain words well. This also added a nasal twang to her voice. She searched far and wide for the right cleft lip and palate surgeon to correct her problem. The patient was then referred to Dr SM Balaji. He is a world renowned cleft lip and palate surgeon.

Surgery planned for the patient

Dr SM Balaji, Cranio-Maxillofacial Surgeon, examined her. He explained to her that she needed a pharyngoplasty surgery to correct this. The patient was in agreement with this and was then scheduled for surgery. Aim of this surgery is to create a dynamic sphincter in the pharynx. Repositioning of the palatopharyngeus muscles achieves this.

The surgical procedure

The patient was then taken to the operating room. She then underwent general anesthesia without complications. Incisions were then made to release the posterior faucial pillars. This included the palatopharyngeus muscles. These muscles were then crisscrossed and sutured together on the posterior pharyngeal wall. A sphincter was thus formed here. This left a small opening or “port” for breathing through the nose.

Successful positive suction test

A positive suction test was then performed after completion of the surgery. This demonstrated a new dynamic velopharyngeal sphincter action. Correction of the patient’s velopharyngeal incompetence was thus completed.

The patient expressed total satisfaction with the results of the surgery. She was then discharged from the hospital.

Primary lip repair for unilateral cleft lip and palate

Primary lip repair for unilateral cleft lip and palate

Unilateral Cleft Lip Repair

A 3-month old baby girl born with wide unilateral cleft lip & palate was brought to our hospital by her parents seeking the best treatment for cleft lip and palate. The parents were greatly perturbed by their baby girl’s condition.

Maxillofacial Surgeon Dr. S.M. Balaji performed the primary unilateral cleft lip repair surgery using Modified Millard’s technique. Following surgery, the baby appearance improved greatly and looked like any other baby of her age with minimal to no scar. The parents were overjoyed with the results. Consecutively cleft palate correction surgery will be done at a later date.


Velopharyngeal insufficiency (Hypernasality) Cleft palate- Pharyngoplasty Surgery(Nasal Speech Correction)

Velopharyngeal insufficiency (Hypernasality) Cleft palate- Pharyngoplasty Surgery(Nasal Speech Correction)

This young man had difficulty pronouncing certain words well and had a nasal twang to his voice. He had been born with a cleft lip and palate and had undergone repair as an infant. He had subsequently developed velopharyngeal incompetence, where there is escape of air through the nose during speech.

He presented at Balaji Dental and Craniofacial Hospital, Teynampet, Chennai for correction of his problem. Dr. S. M. Balaji, Cranio-Maxillofacial Surgeon, examined him and explained to him that he needed a pharyngoplasty surgery for correction of his problem. The patient was in agreement with this and was scheduled for surgery. The aim of this surgery is to create a dynamic sphincter in the pharynx by repositioning the palatopharyngeus muscles.

The patient was taken to the operating room and underwent general anesthesia without complications. Incisions were made to release the posterior faucial pillars, including the palatopharyngeus muscles, which were then crisscrossed and sutured together on the posterior pharyngeal wall to form a sphincter leaving a small opening or “port” for breathing through the nose. A positive suction test was performed after completion of the surgery and showed new dynamic velopharyngeal sphincter action indicating successful correction of velopharyngeal incompetence. The patient recovered from general anesthesia without complications.