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Some children with a cleft palate may require an additional surgery directed at improving their speech. Most children have their primary palate repair at around 1 year of age. Following this initial repair, they undergo a rigorous course of speech therapy with a trained cleft lip and palate speech pathologist who follows the patient during speech development. If they are unable to perform certain sounds and the speech therapist believes they do not have the adequate structure to make the appropriate sounds, surgical intervention may be advised. If surgery is recommended, this is typically performed between 3-5 years of age so that as children enter school they are able to make all the sounds necessary. Speech surgery is generally less of an operation than the primary palatal surgery, meaning that recovery time is less and the child spends less time at the hospital. Because it is on the palate and involves the airway, these patients are typically observed overnight. The speech surgery that each child will have is dependent on what type of natural architecture the child has available to produce speech. The surgeon and the speech therapist will determine what studies need to be performed to determine what exactly this architecture looks like so they can appropriately plan the next operation. Speech therapy is continued following this secondary speech surgery so they can learn how to use their newly constructed palate to produce the appropriate sounds. Speech surgery and therapy are important parts of cleft palate surgery. They are not always necessary, but it’s vital that families are prepared for this potential follow-up care. I always try to have open and honest conversations about this possibility. If you have any questions related to the care or treatment of your child with cleft palate or if you think your child may have a plastic surgery need, please feel free to comment below or contact our clinic at 832-822-3180.
Author
Dr. Edward Buchanan, Plastic Surgeon