How We Approach Cleft Palate Treatment for Our Patients
Parents often receive a diagnosis before their baby is born as part of a routine ultrasound. We encourage you to visit Wellspring Craniofacial Group at this point so that we can talk through treatment and help you feel confident in the journey ahead.
When you come for your appointment, you’ll find our practice to be a warm and inviting space. You will be seen quickly by our experienced staff, and your doctor will spend significant time with you learning about the diagnosis, discussing your concerns, and providing answers to any questions you may have.
Your child’s timeline for treatment will depend on certain factors that we will discuss during your initial consultation, but here is a sample outline to give you an idea of what to expect.
Birth to 3-4 Months of Life
If your child has both a cleft palate and a cleft lip, your doctor will guide you through the early milestones of treatment, which you can learn more about on our “Cleft Lip” treatment page. As with every newborn, the emphasis is on helping your child feed well, and with cleft palate this may require feeding or bottle modifications.
One of the most important techniques that we use in the first few months of a baby’s life is nasal alveolar molding (NAM). The NAM is a small, individually tailored plastic appliance that the baby wears daily to bring together the different parts of the lip. Dr. Hobar was one of the first craniofacial surgeons to use this technique in practice. With the NAM approach, our doctors can promote a significantly better outcome following treatment.
If your baby has both a cleft lip and cleft palate, he / she will have cleft lip surgery at this point. We have performed this procedure for patients with needs ranging from simple to complex, providing outstanding functional and cosmetic results. In some cases, we will also repair the soft palate at the same time, which can be a powerful technique in optimizing good outcomes. We will help your child feel as safe, cared for, and comfortable as possible throughout the experience.
Infants with cleft palates are prone to middle ear infections and fluid buildup. We like to have one of our ENT colleagues evaluate patients in the first several months of life and can place ear tubes if necessary. This is a simple and effective way to prevent hearing loss and chronic infections. The doctors in our practice regularly participate in international mission work, where we incorporate this technique when treating children in some of the world’s most underdeveloped countries.
9-11 Months of Age
Your doctor may recommend repairing your child’s cleft palate surgically at this stage of his or her development. Studies show that:
- Repairing the cleft palate around one year of age gives children the best opportunity for developing normal speech.
- Surgery before this point can negatively affect facial growth.
As with the cleft lip procedure, your child will have the surgery in a pediatric hospital, under the attention of a board certified pediatric anesthesiologist. You can feel confident in the quality of treatment your family will receive both from your Wellspring Craniofacial Group doctor and from the hospital staff. The facilities we choose for surgery are recognized as being among the best in Texas and have great resources and professionals.
Two Years of Age
At this point following cleft palate surgery, our team will begin monitoring your child’s speech development. We want to ensure that scar tissue from surgery doesn’t get in the way of normal speech, which should progress by age four. Speech therapy can improve certain challenges, but about 15% of patients benefit from a follow-up surgical procedure.
Dental Development and Alveolar Bone Grafting
Treatment with Wellspring will give your family a lot to smile about, so we want to make your child’s dental development predictable and cosmetically appealing. A cleft palate that runs through the gum ridge can create certain challenges, which we can address through treatment:
- A combination of NAM therapy and specialized techniques during the cleft lip repair will resolve these concerns for one-third to one-half of patients.
- For other patients, a follow-up surgery will bridge this gap in a natural-looking and aesthetic way. Our doctors often partner with exceptional orthodontists experienced in cleft treatment during this procedure.
Orthognathic Surgery for Cleft Palate Patients
Even with the benefit of cleft palate surgery, a small percentage of patients will experience midface retrusion or midface hypoplasia, conditions in which the midface appears flat, misaligned, or underdeveloped. A combination of orthodontics and craniofacial surgery can correct this condition. We usually recommend that children have a procedure after they have finished developing: 15-17 years for girls and 16-18 years for boys.
Taking the Journey Together
When you and your child begin this transformative journey—diagnosis in hand and the path for treatment ahead—we hope you choose Wellspring to walk with you. The destination may seem beyond a distant horizon, but we know the way, and we will always be there to support and guide you.
And here is Camey now with her husband, Nathan, and three beautiful children.
Wellspring Craniofacial Group welcomes you to visit our practice to discuss a cleft palate diagnosis and how we’ll care for your family. Schedule an appointment with us by contacting our office online or by calling (512) 600-2888.