Surgery
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Palate Surgery
When?
This usually happens when your baby is 9 to 13 months old. The doctors may change this depending on how healthy your baby is.
Why?
The palate (the roof of the mouth) helps make clear speech sounds. This operation closes the gap between the nose and mouth, and lines up the palate muscles at the back of the mouth. This helps the palate move properly, which helps with speech.
How?
Your baby will be asleep during the operation. The surgeon makes some small cuts inside the mouth. First, the inside lining of the nose is stitched together. Next, the muscles are gently freed and stitched together. Finally, the inside lining of the mouth is stitched together in the middle. Sometimes it is hard to bring everything together, so the surgeon makes extra cuts at the sides of the palate, called ‘releasing incisions’, to make this easier. These extra cuts heal quickly, just like the gap left after a tooth is taken out at the dentist.
What Will Happen?
Please tell us if your child is unwell in the week before the operation, for example if they have a runny nose. This matters because being unwell can make the anaesthetic (medicine that puts your child to sleep) and the healing afterwards more risky. Your cleft nurse will call you to answer any questions before the operation.
We will tell you exactly when you can last feed your child before the operation. Click here to find out where to bring your child on the day (link to AH and RMCH specific instructions on how to get to the ward).
You will stay one night on the ward with your baby after the operation. Most babies go home the next day if they are feeding well.
Aftercare
You can feed your child straight after the operation. We recommend soft foods for 3-4 weeks afterwards. Click here for advice about feeding your child.
- We will give you medicine to use after the operation. This may include paracetamol, ibuprofen, or diclofenac. If your child is still in pain, we may also give a stronger medicine called oral morphine. You will be given some medicines to take home before you leave hospital.
Please try to avoid using a dummy for at least 3-4 weeks after the operation.
What Are The Risks
Signs of infection include a high temperature, being sick, not feeding well, redness around the wound, or bad-smelling fluid coming from the wound. We can usually treat this with antibiotics (medicine that fights infection). We also give antibiotics during the operation to help stop this happening.
A little blood in your child's saliva or coming from the nose is normal. In rare cases, fresh bleeding can come from the wound. If this does not stop within 10 minutes, bring your child to A&E (Accident and Emergency). If this happens a week after the operation, it could be a sign of infection. You can contact the on-call cleft nurse if you need advice.
Breathing problems are rare. Some babies need a small tube in their nose to help them breathe while the swelling goes down.
A fistula is a small hole between the nose and the mouth. Sometimes a hole forms in the palate after the operation. This does not always need treatment, but if it is causing problems for your child, we sometimes offer an operation to repair it when they are older.
Most children only need one palate operation to develop normal speech. However, about 3 in every 10 children may still have some speech difficulties, which can be helped by another operation.