Cleft Lip and Palate Treatment Options
The repair of the cleft lip and cleft palate at an appropriate age is important for the child to be able to develop understandable speech, and to prevent difficulty with eating and swallowing. During a consultation with our cleft lip and palate specialists, each child will receive an individualized functional and cosmetic assessment that will determine the best approach necessary for the highest standards of functional and aesthetic reconstruction. Depending on the extent of the case, your child's treatment team may include:
- Ear, nose, and throat doctors (called ENTs or otolaryngologists)
- Facial plastic surgeons, or ENTs that specialize in cleft lip and palate
- Oral surgeons
- Pediatric dentists
- Auditory or hearing specialists
- Speech therapists
- Genetic counselors
- Social workers
Surgical interventions to repair cleft lip and palate deformities may include speech surgery for velopharyngeal insufficiency, alveolar bone grafting and gingivoperiosteoplasty, cleft rhinoplasty, orthodontics, and complex dental care.
In addition to surgical interventions, comprehensive and ongoing speech therapy is a part of our routine treatment plan with cleft palate patients. The cleft team at NYEE is composed of multidisciplinary groups of specialists that include speech and swallow therapists who specialize in the care of the cleft palate patient. Our speech team monitors developmental progress with many cutting-edge tools that determine the amount of air escaping through the nose, and uses three-dimensional video imaging to assess the motion of the palate both before and after repair.
Selecting the Best Treatment for Cleft Lip and Palate
Before proposing a customized treatment plan for cleft lip and palate, the specialists at NYEE consider the functional and aesthetic factors of each case. From a functional standpoint, the following questions need to be answered to determine the appropriate courses of action:
- Is this affecting the child's feeding and growth?
- Is this affecting the child's speech and intelligible language development?
- Is this affecting the child's hearing?
As far as aesthetic considerations, the following questions need to be answered to determine the appropriate courses of action:
- Is this a unilateral (one sided) or bilateral (two sided) cleft lip?
- Is this a complete cleft of the entire lip going through the floor of the nose?
- Is this a partial cleft lip affecting only some parts of the visible lip?
- Regardless of the size of the cleft, how much of the nasal shape and form is affected, and from how far away is the external nasal asymmetry noticed?
Typical Ages for Treatment of Cleft Lip and Palate
Treatments for cleft lip and palate are generally recommended at the following ages:
Birth: Experts may diagnose clefting and associated anomalies and create a tentative plan of care, including immediate feeding interventions. We may identify whether the child may be a candidate for a Naso-Alveolar Molding device (NAM).
10 Weeks: Experts may perform cleft lip repair and cleft nose repair, and insert ear tubes. This may be delayed to four to five months of age in certain situations, including the use of NAM.
9 Months to One Year: Experts may perform cleft palate repair.
3-5 Years: Experts may provide speech therapy and adjunctive surgical procedures.
10-14 Years: Experts may perform bone grafting for Alveolar clefting.
14-17 Years: Experts may perform cleft rhinoplasty for definitive nasal repair when necessary.