Topic Overview

Additional treatment may be required after surgery for cleft palate. This includes:

• Speech therapy. Children with cleft palate may develop speech problems and should have their speech monitored throughout their school years. Speech problems usually improve with therapy, although in some cases, more surgery is needed.
• Treatment for uneven teeth. Children with cleft palate often have problems with uneven permanent teeth because of a misshapen or small jaw. They may need to wear braces to straighten their teeth. Often the upper jaw needs to be lengthened to fit the size of the lower jaw. Bone from the hip may be surgically placed in the upper jaw to lengthen it. Treatment for uneven teeth is provided by a specialist (orthodontist) or a pediatric (children's) dentist.
• Surgical repair for a small opening between the mouth and nose. After initial surgery, a small opening sometimes still exists between the mouth and the nose. If this hole is not repaired, food or fluids may come out through the nose when the child eats and drinks.
• Treatment for infections of the sinuses and middle ears. Children with cleft palate are more likely to develop these types of infections, which can lead to temporary or permanent hearing loss. It is important to diagnose and treat all infections quickly. Some children need tubes surgically inserted in the ears (myringotomy) to help the middle ear function properly.
• Treatment for hearing loss. Hearing defects not caused by fluid buildup or ear infections may occur along with cleft palate. Children with cleft palate who are having problems with speech or reading may have hearing loss.
• Emotional counseling. Children with cleft palate may need help dealing with their feelings about the defect. Older children and teens may benefit from workshops or group therapy with others their own age who have similar problems.