Cleft Palate

Cleft palate and cleft lip are birth defects that affect some one out of every 800 babies.  With a cleft palate, the right and left sides of the roof of the mouth do not fuse, resulting in a separation

Great advances have been made in the treatment of clefts.  If your child was born with a cleft lip or a cleft palate and your doctor has recommended surgery, you’ll want to consult with a specialized team as early as possible.  Because the treatment of cleft palates often requires the skills of many medical professionals, a team approach is essential.  Children born with cleft palates may also have problems difficulties with feeding in addition to dental issues as well as  speech and hearing difficulties.  These issues  will need to be addressed along with having the cleft palate repaired.  Cleft Lip and Palate teams are located across the country and often include a plastic surgeon, pediatrician, dentist, speech and language specialist, social worker, hearing specialist, ear-nose-throat specialist, psychologist, nurse and genetic counselor.  Dr.   Duboys is the founder and Emeritus Co-director of the Cleft and Craniofacial team at the State University of New York – Stony Brook Medical Center and has been performing Cleft surgery since 1985. 

When the roof of the mouth doesn't grow together properly, the condition is called a cleft palate. To repair it, the surgeon will make an incision along both sides of the cleft.	Tissue is drawn together from both sides of the cleft to rebuild the roof of the mouth.

All surgery carries the risk of complications.  The goal of cleft palate surgery is to close the opening in the roof of the mouth, thus allowing the child to eat and learn to speak properly.  Occasionally, a second operation may be required if the palate heals poorly or if poor speech results. 

During your consultation, Dr.  Duboys will discuss all details of the cleft palate procedure and take the time to answer any questions that you may have.  Insurance covers most cases of cleft palate surgery and our staff can assist you in checking with your insurance carrier. 

A cleft palate may involve just a tiny portion at the back of the roof of the mouth or it may involve a complete separation extending from the front of the roof of the mouth to the back.  Surgery to repair a cleft palate most often performed on children between the ages of nine and eighteen months.  This allows the baby to be bigger and more tolerant of the surgery. 

During the surgery, an incision is made on both sides of the separation.  The surgeon will then rebuild the palate by moving tissue from each side of the cleft to the center of the roof of the mouth.  This also joins the muscle together and creates enough length in the palate to allow the child to eat and speak properly. 

Some soreness and pain can be expected during the first day or two after cleft palate surgery and can be alleviated with medication.  An intravenous line will be necessary during this time to maintain fluid levels as the child will not be able to eat or drink as much as usual.  To prevent the baby from rubbing the treatment area, elbow restraints may be necessary.  You will be provided with specific instructions on feeding your child for the first few weeks after surgery and these must be closely followed for the palate to heal properly. 

Ear infections are frequently seen with cleft  children as the cleft may interfere with the normal function of the middle ear.  As such, the ear-nose-and-throat surgeon on the Cleft Palate Team may recommend that a small plastic ventilation tube be inserted in the eardrum.  This will allow for proper drainage and air circulation.  Future surgery may also be recommended to refine the shape and function of the lip, nose, gums and palate.