Adjustment Surgery

Description:

Complete clefts of the lip and palate usually require some adjustment of the original repair.  This is not because a procedure has failed, but that some repairs take time, and things can change as your child develops. 
Here are some of the other procedures that may be required.

Fistula: Sometimes a small hole (fistula) will remain in the palate after repair.  Fistulas are generally repaired when they are affecting your child’s development.  There needs to be at least 6-9 months between repairs to enable the scar tissue around the repair to relax.

Pharyngoplasty and palate lengthening:  This is where speech is not progressing as it should despite the palate being repaired. Pharyngoplasty is a term to describe a group of operations which change the shape of the throat. Palate lengthening realigns the muscles of the soft palate and lengthens it so that it can reach the back of the throat.  Sometimes a mixture of procedures can be done.

Lip adjustments and lip trims:  Sometimes the lip scars will stretch or change with growth.  If it is felt that the shape or look of the lip could be improved, then minor lip revision can be offered.  This can be done at any age, and is often done prior to starting school.

Nose shape:  If the nose is not corrected at the time of primary lip surgery, nose shapes can also be revisited.  This is generally done when the child is older, in their teens and 20’s and becomes the individual cleft patient’s choice.  It is a very personal choice, which involves individuals weighing up a number of often conflicting factors.
Things to talk about:

• How to develop your child’s self esteem.
• How to identify when their health may be affected by how they look or how they are perceived by their peers.
• Side-effects of treatment may outweigh the benefits.  Careful consideration needs to be entered into.  This is a personal decision and the child should always be involved.

Important information:

• The cleft is only a small part of who your child is.  There is a balance to be achieved between acknowledging the things your child has gone through and putting too much emphasis on the cleft.
• Remember, as parents we don’t own the issue of the cleft, our role is to teach, guide and be there for our children when they need us.