A cleft palate may be unilateral or bilateral, involve the soft palate only, soft and hard palate, and extend through the gum where teeth will eventually erupt. The goals of cleft palate repair include re-establishment of muscle continuity in the soft palate and re-approximation of the palate lining across the cleft. The palate lining is shifted from the sides to the center and stitched together. The bare areas left on the sides heal spontaneously.
Cleft palate repair is normally performed around age 6 to 9 months, in time for speech development. When present, a cleft through the gum, or alveolar process, may also be closed at this time; however, a bone graft may be required around age 6 to 8 years to anchor the eruption of a permanent tooth.
Many children will require speech therapy and, occasionally, a surgical pharyngoplasty, to correct nasal speech. The timing of these surgeries for tooth eruption and speech is coordinated by the Cleft Palate Team.
Children with cleft palates may have problems with hearing, speech and teeth eruption. Cleft palate team members, in addition to plastic surgeons, include audiologists, ear specialists, speech pathologists and therapists, dentists, orthodontists, and oral surgeons.