Cleft Palate Repair

The Surgery

A palatoplasty (PAL-at-oh-plast-ee) is a procedure to repair your child’s palate that is usually performed around 12 months of age. The cleft is closed down the middle in layers. The nasal lining is closed first, followed by aligning the muscles in the soft palate, and lastly the oral lining is closed. All sutures are dissolvable. There will be two incisions behind the teeth that help decrease some tension on the palate closure. A material that will look black may be sutured into these incisions and will slowly dissolve as the incisions heal.

What to Expect Immediately Following Surgery

Your child will be admitted to the hospital for 1-2 days following surgery for pain control, to monitor fluid intake, and to watch for breathing problems. The palate may ooze blood and cause some blood-tinged saliva in the hours after. It is expected that your child will have some pain related to the surgery but the pain should improve over the following 2-3 days. Your child will be on a liquid diet immediately after surgery. Appropriate fluid intake is important to prevent dehydration. Your child may not want to drink immediately after surgery, but this should improve over a few days. Some surgeons may place a tube into the nose or a stitch in the tongue at the end of surgery as a precaution if your child has any trouble breathing. This is removed the day after surgery

What to Expect in the Weeks Following Surgery

The sutures in the mouth will dissolve over a couple of weeks. You may start to notice some small changes in your child’s speech after surgery. After 3 months, your child will have a speech evaluation by the speech therapist. For some patients, there may still be a small opening called a fistula in the palate that can affect speech or feeding that may require another surgery to repair

What to Expect at Home

  • Activity: Light activity for 2 weeks. Avoid anything hard or sharp in the mouth. Small children may need to wear arm braces to prevent them from putting their hands or objects in their mouths.
  • Diet: Your child will be on a modified diet for 3-6 weeks following surgery (all liquid diet for 1-2 weeks, then soft food).
    • For young children, sippy cups are preferred over bottles. Rinse mouth with water after eating.
  • Pain: Tylenol or prescription pain medication may be taken for discomfort.

When to Call the Doctor’s Office

  • Worsening pain or discomfort
  • Breakdown or opening of the mouth or incision
  • Heavy bleeding from the mouth
  • Redness or drainage of pus from the incision
  • Unable to tolerate drinking fluids