Cleft Palate Repair:Closure of cleft palate with pushback palatoplasty. A) Two mucoperiosteal flaps are outlined. B) Flaps are elevated off the hard palate. C,D) The abnormal levator muscle insertion to the hard palate is identified and cut free. E) The nasal lining is closed as a separate layer and the levator muscle reapproximated. F) The palatial mucoperiosteal flaps are closed in a V-Y fashion.
Surgical treatment of the cleft palate is best accomplished in one surgical procedure before the child reaches 12-14 months of age. The cleft palate is surgically closed by elevating two muscoperiosteal flaps. The levator muscles are elevated, redirected and repaired; and a three layer closure of nasal mucosa, muscle and oral mucosa accomplished. Surgery under general anesthesia usually lasts about 2 hours. Special precautions as those after the repair of the cleft lip are necessary for 2-3 weeks. We prefer that the child be weaned from the bottle and pacifier prior to the palatal repair. No hard or crunchy foods are allowed for 3 weeks post operatively.
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