Cleft lip and palate is the commonest craniofacial abnormality in the UK, with around 1:700 births affected.

Children with a cleft lip and palate are best looked after in a multidisciplinary environment, and all regions of the UK will have a MDT available.

Cleft lip repair typically takes place around 3-6 months and cleft palate repair between 9-12 months.

Secondary Speech surgery

Around 25% of children with a cleft palate will require a secondary operation, following their initial palate repair, to ensure adequate speech. This surgery can take the form of re-repair of the palatal muscles, possibly with use of tissue from the inside of the cheek to help give support and length to the palate. This is known as a buccinator flap. Another alternative is an operation, called a pharyngoplasty, which alters the shape at the back of the throat to allow easier closure of the palate against the back wall of the throat, thus helping with speech. Decisions regarding secondary speech surgery are made in conjunction with a speech therapist specialising in palatal dysfunction, and following investigations into the function of the palate, either by X-ray (videofluroscopy study) or flexible nasoendoscopy.

Non-cleft palatal speech dysfunction (velopharyngeal dysfunction)

Speech disorders in children can be very complex, and have a number of different causes. Speech disorders caused by failure of the palate to adequately close typically give rise to ‘hypernasal’ speech. This is when excess air comes down the nose on certain sounds, and sometimes this is associated with a snorting noise or facial grimace. If you are worried about your child having a speech disorder associated with dysfunction of the palate, seeking an opinion from a speech therapist and surgeon specialising in palatal disorders, often the specialist cleft lip and palate team, is the most appropriate course of action.

Hearing loss

Otitis media with effusion is common in children, but even more common in children with a cleft palate. This is due, at least in part, to the abnormally inserted muscles resulting from a cleft of the palate. One of the affected muscles also helps drain fluid from the middle ear. Children with a cleft palate should have regular hearing tests until the age of 5.