Surgery
Ned to contact us?
Get in touch with our admin team
Palate Surgery
- When? Between 9 and 13 months but this can be adjusted according to the health of your child.
- Why? The palate is very important for helping to create recognisable speech sounds. Palate surgery aims to restore the separation between the nose and the mouth, and to align the palate muscles at the back of the mouth. Aligning the muscles should help the palate to move backward to help with speech sounds.
- How? This procedure happens with your baby asleep. Some cuts are made in the mouth. First the lining of the nose is stitched together from inside the mouth. Next the muscles are released and stitched together. Finally, the lining of the mouth is stitched together in the midline. Sometimes, it is very tight to pull things together and some ‘releasing incisions’ (cuts at the side of the palate) are made to reduce tension and allow everything to close in the midline. The releasing incisions heal quickly; just like a tooth socket when a tooth is removed at the dentist.
- What will happen?
- Before the operation: It is important that you let us know if your child is unwell in the week prior to the operation (for example, if they have a runny nose). This is important because it can increase the risks around anaesthetic and post operative wound problems. Your cleft nurse will be available to answer your questions in the run up to surgery.
- On the day of surgery: You will be provided with specific instructions on when you can feed your child before the operation. Please find information on where to bring your child on the day of surgery here (link to AH and RMCH specific instructions on how to get to the ward).
- Going home: You will stay one night on the ward with your baby after your surgery. Most babies go home the day following surgery if they are feeding well.
- Aftercare:
- Eating and drinking: You can feed your child immediately following surgery. We advise a soft diet for 3 weeks following surgery Click here for advice about feeding and what you should be feeding your child (link to nursing feeding advice)
- Pain relief: We will prescribe medication to use following surgery. This may include paracetamol, ibuprofen or diclofenac. Oral morphine may also be prescribed (if appropriate) for pain that is not controlled by the regular medication. You will be provided with these on leaving the hospital. Click here for advice on how to recognise signs of pain in your baby (link to information on recognising when babies are in pain).
- Dummies: Please do not use a dummy for at least 3 weeks following surgery
- What are the risks?
- Infection: signs of infection can be high temperature, vomiting, not feeding well, bleeding or foul-smelling discharge from the wound. This can usually be treated with antibiotics and we use preventative antibiotics during the surgery itself to reduce the risk of this happening.
- Bleeding: some blood stained nasal discharge or saliva is normal. However, in rare cases there is fresh bleeding from the wound. If this does not settle within 10 minutes, you should bring your child to A and E. If this happens a week after surgery, it may also be a sign of infection.
- Breathing problems: these are rare, but some babies require a tube in their nose to help them to breathe after surgery whilst the swelling settles down.
- Fistulae: This word means a hole. Sometimes there a hole forms in the palate after surgery. This doesn’t always require treatment, but if it is affecting your child, there are operations we can offer to repair the hole.
- Speech problems: Most children only require one palate surgery to develop normal speech. However, 20-30% of children will still experience some difficulties when speaking that can be improved by further surgery.
Some Questions You Might Have
Here are some frequently asked questions that provide straightforward answers about cleft lip and palate surgery, helping families understand the condition, what it means, and how it is treated. These questions cover the topics parents and carers often want to know first, offering clear information to support you from the beginning of your journey.