Our Summary

This research examined whether different surgical techniques used to repair a cleft palate in children affected their speech and ability to control the flow of air through their nose and mouth (velopharyngeal competency) by the age of 5. The study involved 448 children with a cleft lip and palate from five different countries. The researchers found that the type of surgery used to repair the cleft palate did not significantly affect the child’s speech or velopharyngeal competency at age 5. However, they did find differences in the additional care required after the surgery, such as the need for further surgeries, the occurrence of fistulae (abnormal connections between the mouth and nasal cavity), and the number of speech therapy sessions needed.

FAQs

  1. Does the type of surgical technique used to repair a cleft palate affect a child’s speech and ability to control the flow of air through their nose and mouth?
  2. What additional care might be required after cleft palate surgery?
  3. Was there a significant difference in outcomes based on the type of surgery used to repair the cleft palate in the study’s findings?

Doctor’s Tip

One helpful tip a doctor might give a patient is to follow all post-operative care instructions carefully to ensure the best possible outcome. This may include attending follow-up appointments, practicing speech exercises recommended by a speech therapist, and seeking additional surgeries or interventions if needed. It is important to communicate with your healthcare team about any concerns or issues that arise during the recovery process. By following these recommendations, patients can help optimize their results and improve their overall quality of life after cleft palate surgery.

Suitable For

Patients who are typically recommended cleft palate surgery are infants and children born with a cleft lip and palate. This includes patients with unilateral or bilateral cleft lip and palate, as well as patients with submucous cleft palate. In some cases, adults with untreated cleft palate may also be recommended for surgery to improve speech and function. The decision to recommend surgery is typically made by a multidisciplinary team of healthcare professionals, including plastic surgeons, otolaryngologists, speech therapists, and other specialists.

Timeline

Before cleft palate surgery:

  • Diagnosis of cleft palate either during pregnancy through ultrasound or after birth
  • Consultation with a team of healthcare professionals including a pediatrician, surgeon, speech therapist, and dentist to discuss treatment options
  • Preparation for surgery including pre-operative appointments and tests
  • Education on post-operative care and potential complications
  • Surgery typically performed between 6-12 months of age

After cleft palate surgery:

  • Recovery period in the hospital for a few days to monitor for complications
  • Follow-up appointments with the surgical team to monitor healing and address any concerns
  • Speech therapy to help with communication and feeding difficulties
  • Monitoring for any issues such as fistulae or need for additional surgeries
  • Continued care and support from a multidisciplinary team throughout childhood and adolescence to address any ongoing concerns.

What to Ask Your Doctor

  1. What are the different surgical techniques available for cleft palate repair and which one do you recommend for my child?
  2. What are the potential risks and complications associated with cleft palate surgery?
  3. How long will the recovery process take and what can I expect during the post-operative period?
  4. Will my child require additional surgeries or treatments in the future?
  5. How soon after the surgery can my child start speech therapy?
  6. What are the long-term effects of cleft palate surgery on speech and velopharyngeal competency?
  7. How often will my child need follow-up appointments after the surgery?
  8. Are there any specific dietary or lifestyle restrictions my child should follow after the surgery?
  9. How can I best support my child during the recovery process and beyond?

Reference

Authors: Lohmander A, Persson C, Willadsen E, Lundeborg I, Alaluusua S, Aukner R, Bau A, Boers M, Bowden M, Davies J, Emborg B, Havstam C, Hayden C, Henningsson G, Holmefjord A, Hölttä E, Kisling-Møller M, Kjøll L, Lundberg M, McAleer E, Nyberg J, Paaso M, Pedersen NH, Rasmussen T, Reisæter S, Søgaard Andersen H, Schöps A, Tørdal IB, Semb G. Journal: J Plast Surg Hand Surg. 2017 Feb;51(1):27-37. doi: 10.1080/2000656X.2016.1254645. PMID: 28218551