
Cleft Palate Repair
Having a new baby is a tremendous event, and when there are unanticipated health issues such as a cleft, the emotional impact can be overwhelming! First know that you did nothing to make this cleft happen. Also, take time to educate yourself as much as possible, be an advocate for your child, and foster a strong self-esteem that benefits every child.
Clefting is one of the most common birth defects in the United States, occurring in about one out of every 700 births. While we know there are genetic and environmental factors, why a cleft occurs is still largely unclear. We do know that very early on in development (in the first one to two months of gestation) we all have clefts that go on to fuse and close. When this does not occur, various combinations and severities of clefts may still be present at birth.
We highly recommend you research your area for a multidisciplinary cleft team. I am affiliated with the Rose Hospital Cleft and Craniofacial Team. If you were fortunate to have had an ultrasound make the diagnosis during your pregnancy, please try to meet with the team coordinator or plastic surgeon prior to the arrival of your baby. There are also fabulous resources available on the Internet through www.cleftline.org, the American Cleft Palate Association.
In general, I perform the first lip surgery around 3 months of age. If the cleft is wide or bilateral, I prefer to separate the repair into two stages, performing an “adhesion” as the first stage, and formal repair or second stage at the same time that the palate is repaired (between 9 and 18 months of age).
P.E. tubes are usually placed in the ears by an Otolaryngologist at the time of the palate surgery. If a revision of the lip or nose is necessary, this is usually considered at age 4-6, or whenever the family feels is appropriate. We may also need to do additional surgery to help correct speech issues that don't respond adequately to speech therapy.
Bone grafting to the space in the gum line and jaw surgery, if needed, is performed by an Oral and Maxillofacial surgeon after preparation by an orthodontist. A formal cleft septorhinoplasty is then performed for functional (breathing) and aesthetic reasons in the teen years.



