Dr. Patrick Chan
Clinical Fellow
Topic
Current Concept in Cleft Surgery
Chapter 13: Modern Cleft Palate Repair: Controversies, Surgical Techniques, and Postoperative Care
This chapter reviews modern cleft palate repair, emphasizing that successful treatment extends beyond palatal closure to achieving normal speech, preserving hearing, and minimizing adverse effects on maxillary growth. It discusses major controversies in palatoplasty, including optimal timing, single-stage versus two-stage repair, management of Eustachian tube dysfunction, selection of hard and soft palate techniques, and postoperative care. The authors highlight evidence favoring timely single-stage repair, commonly around 9 months of age, to support speech development while accepting that maxillary deficiency can be managed later. Practical postoperative issues such as feeding, airway support, restraints, antibiotics, and discharge planning are also addressed.