Cleft Palate Repair Surgery in Thailand

Cleft Palate repair surgery (Palatoplasty)
Cleft palate is repaired by a surgical procedure to reconstruct or repair the palate of the patient. Palatoplasty is a common cleft palate repair procedure that is performed to seal the abnormal cavity between the mouth and the nose. It helps the patient in attaining normal speech. Moreover, it aids the patient to breathe and swallow, and helps in the normal development of the mouth structures.

At was age is it recommended to undergo surgery?
Cleft palate is repaired when the child is six to 12 months old.
Repeated and combined surgical procedures are often required when the child grows.

How is Cleft Palate repair surgery performed?

• The patient is given medications and fluids through an intravenous line.
• The cleft palate is repaired by attaching tissue on both sides of the cleft.
• The opening to the nose is sealed and muscles are also attached that aids in lifting the palate.
• Several layers are added to reconstruct the palate.

How to prepare for Cleft Palate repair surgery?

• The child undergoes a complete physical examination.
• The child’s blood is tested and the medical history is recorded.
• The doctor should be informed about any medication that the child is taking. This includes vitamins and supplements.
• Certain medication that the child is taking may be stopped some days before the surgery.
• The doctor should be informed if the child has other illnesses and abnormalities.
• The pediatrician will monitor the child’s nutrition and weight. The child needs to gain a certain amount of weight for the surgery. If this is not attained by oral feeding, the child may be fed using a nasogastric tube.
• Approximately three weeks prior to the surgery, the child’s diet should consist of food that is of a thicker consistency.
• As cleft palate can cause ear problems, the doctor may recommend the use of Tympanostomy tubes during the surgery.

Duration of procedure/surgery:
2 to 3 hours

Days admitted:
2 to 3 days

Anesthesia:
General anesthesia

Recovery:
- The child’s pulse oximetry is monitored for more than 24 hours.
- A liquid diet is given to the child for two to three days.
- If a liquid diet cannot be given, the child is given hydration intravenously.
- Sometimes pharyngoplasty and other speech therapies are needed to repair speech.
- The requirement of additional surgeries is determined only after the child is four to five years old, when the speech development is almost complete.

Risks:
- Bleeding
- Airway obstruction
- Development of a fistula between the mouth and nose
- Dehiscence of the palate
- Scarring
- Tissue loss
- Hypernasal speech

After care:
- The child’s mouth should be rinsed with water after the child is fed.
- A regular nipple should be avoided for three to four weeks.
- Solid food should be soft.
- A follow-up appointment should be scheduled after a week or 10 days from the date of discharge.
- Arm restraints may need to be placed if recommended by the surgeon.
- Rough play or activity should be avoided for some period.
- The child should not be exposed to other sick children to avoid infection.

The doctor should be informed if there is
- Bleeding from the mouth
- Swelling of face
- Pain that is not reduced by medication
- Fever that is higher than 101.5 degrees F