Ten things you should know about Cleft-Palate

• •  A cleft palate is a split or opening in the roof of the mouth. A cleft palate can involve the hard palate (the bony front portion of the roof of the mouth), and/or the soft palate (the soft back portion of the roof of the mouth).
  • Cleft palate patients have problems with food and liquids passing from the mouth back through the nose. Children with a cleft palate may need to wear a man-made palate to help them eat properly and ensure that they are receiving adequate nutrition until surgical treatment is provided.
  • Many children with cleft palate are at risk for fluid buildup in the middle ear, which can lead to ear infections and even hearing loss. So kids with cleft palate should have their ears and hearing checked once or twice a year, or more if they are having hearing problems.
  • Children with a cleft lip and palate often have dental problems. These can include small teeth, missing teeth, extra teeth (called supernumerary), or teeth that are out of position. They may have a defect in the gums or alveolar ridge (the bone that supports the teeth). Ridge defects can displace, tip, or rotate permanent teeth or prevent permanent teeth from coming in properly.
  • Kids with cleftpalate may have speech problems after surgical repair. Most often, this means that a child’s voice is hypernasal (sounding like the child is talking through the nose). This happens because the palate doesn’t move well enough to prevent air from leaking out of the nose.
  • Repair of a cleftpalate often requires multiple surgeries over the course of child’s life up to adolescence or early adulthood. The first surgery to repair the palate usually occurs when the baby is between 6 and 12 months old.
  • The initial surgery creates a functional palate, reduces the chances that fluid will develop in the middle ears, and aids in the proper development of the teeth and facial bones.
  • Children with a cleft palate may also need a bone graft when they are about 8 years old to fill in the upper gum line so that it can support permanent teeth and stabilize the upper jaw. Once the permanent teeth grow in, braces are often needed to straighten the teeth.
  • About 20% of children with a cleftpalate require further surgeries to help improve their speech. These surgeries along with training given by speech pathologist help the patient in developing a normal speech.
  • Comprehensive care for cleft lip and palate cases from primary surgeries to secondary surgeries, speech surgeries, speech training and other associated cosmetic corrections for cleft patients, and also required dental treatment services are being provided by an experienced team of doctors at Richardson’s Dental and Craniofacial Hospital, Nagercoil under the expert guidance of Dr. Sunil Richardson.

Facesurgeon’s Protocol in cleft palate surgery:

1. 1. • Cleft lip surgery @ 5 kg body weight
      • NAM or Naso Alveolar Moulding in cases required.
      • Cleft palate surgery @ 10 months old
      • First Speech assessment @ 3 yrs
      • Secondary Alveolar Bone Grafting @ 8 years
      • Fixed Orthodontics @ 11 years onwards
      • Secondary Speech Surgeries are done based on the problem the patient has and it varies especially in patients who have had their primary surgery elsewhere.