Cleft Palate Repair Workup

  • Author: Pravin K Patel, MD; Chief Editor: Jorge I de la Torre, MD, FACS   more...
 
Updated: Feb 1, 2012
 

Laboratory Studies

  • Routine laboratory studies are noncontributory in otherwise healthy infants with cleft palate. Some centers obtain a blood count as a routine study before performing surgery on a child with cleft palate. The authors do not find this necessary unless some other associated medical conditions coexist.
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Imaging Studies

  • Routine imaging studies are noncontributory in otherwise healthy infants who undergo primary cleft palate repair.
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Diagnostic Procedures

  • Early collaboration with an audiologist and an otolaryngologist, including examination and early audiologic assessment, prevents long-term hearing deficits.
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Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Pravin K Patel, MD  Associate Professor of Surgery, Division of Plastic Surgery, Northwestern University, The Feinberg School of Medicine; Chief of Plastic and Craniofacial Surgery, Shriner's Hospitals for Children; Head of Craniofacial Surgery, Children's Memorial Hospital

Disclosure: Nothing to disclose.

Coauthor(s)

Raja Ramaswamy, MS  Chicago Medical School at Rosalind Franklin University of Medicine and Science

Raja Ramaswamy, MS is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Mitchell F Grasseschi, MD  Assistant Professor, Department of Plastic Surgery, Northwestern University, The Feinberg School of Medicine; Private Practice, Plastic and Reconstructive Surgery

Disclosure: Nothing to disclose.

Mary M O'Gara, MA, CCC-SLP  Associate Professor, Department of Plastic Surgery, Northwestern University Medical School; Speech/Language Pathologist: Consultant to the Cleft Lip and Palate Institute, Allied Health Professional Staff Appointment, Shriners Hospital for Children

Mary M O'Gara, MA, CCC-SLP is a member of the following medical societies: American Cleft Palate/Craniofacial Association and American Speech-Language-Hearing Association

Disclosure: Nothing to disclose.

Erin K McGraw, MA, CCC-SLP/L  Speech-Language Pathologist, Cleft Palate and Craniofacial Team, Shriner's Hospital for Children of Chicago

Erin K McGraw, MA, CCC-SLP/L is a member of the following medical societies: American Cleft Palate/Craniofacial Association and American Speech-Language-Hearing Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Larry Hollier, Jr, MD  Assistant Professor, Department of Plastic Surgery, Baylor University College of Medicine

Larry Hollier, Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, American Society of Maxillofacial Surgeons, AO Foundation, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

S Anthony Wolfe, MD  Chief, Division of Plastic Surgery, Miami Children's Hospital; Voluntary Professor, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Miami School of Medicine

S Anthony Wolfe, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Plastic Surgeons, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Society for Aesthetic Plastic Surgery, American Society of Maxillofacial Surgeons, American Society of Plastic and Reconstructive Surgery, Florida Medical Association, and Southeastern Society of Plastic and Reconstructive Surgeons

Disclosure: Nothing to disclose.

Nicolas (Nick) G Slenkovich, MD  Director, Colorado Plastic Surgery Center

Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS  Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham School of Medicine; Director, Center for Advanced Surgical Aesthetics

Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors Alexander Margulis MD, Kara K Criswell MD, and Bryan K Criswell MD to the development and writing of this article.

References

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Anatomy of the palate.
The von Langenbeck repair. Two bipedicle mucoperiosteal flaps are created by incising along the oral side of the cleft edges and along the posterior alveolar ridge from the maxillary tuberosities to the anterior level of the cleft. The flaps are then mobilized medially with preservation of the greater palatine arteries and closed in layers. The hamulus may need to be fractured to ease the closure.
Two flap palatoplasty. After lateral relaxing incisions are performed, bilateral flaps are elevated based on greater palatine vessels.
Two-flap palatoplasty (continued). Closure of the nasal mucosa is performed. The hamulus may be fractured, the muscle is repaired, and the oral mucosa is closed as a separate layer.
Double-opposing Z-plasties. Furlow's single-stage palatal closure technique consisting of double opposing Z-plasties from the oral and nasal surfaces. The double Z-plasty minimizes the need for lateral relaxing incisions to accomplish closure. The palate is lengthened as a consequence of the new position of the velar and pharyngeal tissues.
Millard modification of Kernahan striped-Y classification for cleft lip and palate. The small circle indicates the incisive foramen; the triangles indicate the nasal tip and nasal floor.
 
 
 
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