Surgery
Ned to contact us?
Get in touch with our admin team
Speech Surgery
When?
From age 3 onwards.
Why?
Most children with a cleft palate develop normal speech after palate surgery. However, 3 in every 10 children need another operation to help their speech. This operation may also help children with a submucous cleft palate (a hidden cleft). Some children’s palates do not close properly against the back of the throat during speech that can cause air escape through the nose. This is called VPI or VPD (velopharyngeal insufficiency or dysfunction). These children may also need speech surgery.
How?
Your child will be asleep during the operation. The way we do speech surgery depends on what we find when we see your child, and what operations they have had before.
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 is there 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 child after the operation. Most children go home the day after surgery if they are feeding well. Some children need to stay a little longer.
Aftercare
Your child is allowed to eat and drink straight after the operation. We recommend soft foods for 3-4 weeks afterwards. Click here for advice about feeding your child.
We recommend giving regular paracetamol and ibuprofen for up to a week after surgery. We will give you these medicines before you leave hospital.
What Are The Risks?
These risks are similar to the risks of palate surgery.
Signs of infection (germs getting into the wound) include a high temperature, being sick, not feeding well, bleeding, or bad-smelling liquid 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 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 your cleft nurse for advice.
Breathing problems are rare following palate surgery. A few children need a small tube in their nose to help them breathe while the swelling goes down.
It is quite common for the stitches at the sides of the palate to come apart, or to take longer to heal. This is usually nothing to worry about, and it heals by itself, like the gap left after a tooth is removed.
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 having speech surgery only need one speech operation. However, some need more than one. It can often take some time for any benefits of the surgery to show in your child’s speech. The aim of speech surgery is to reduce air escaping through the nose during speech. Some operations, such as pharyngoplasty can also make your child’s speech sound like they have a blocked nose when they talk.
Some children snore after speech surgery. If your child has a pharyngoplasty, this snoring will nearly always happen and will last for life.