Surgical management of clefts

A. J. Yonkers, G. F. Moore

Research output: Contribution to journalArticlepeer-review


Surgical repair of the lip and soft palate is planned according to the rule of tens. Tympanostomy tubes are inserted at the same time as the cleft repair to prevent the occurrence of serous otitis media. The hard palate and alveolar clefts are obturated with an orthodontic appliance in the preadolescent patient to complete separation of the nasal from the oral cavities. This allows undisturbed growth of the palatal shelves and also permits the child to develop speech with as near normal anatomy as is possible. Obturation of the palatal cleft is maintained until nine years of age to achieve oral and nasal separation as well as to prevent arch collapse through counteracting the tension produced by the repaired labial musculature. In some cases, earlier attempts at palatal closure can be made when the palatal shelves grow and narrow the cleft gap to the point where they are nearly abutting each other. We believe that using this method of early closure of the cleft lip and soft palate, coupled with a hard-palate obturator, allows the child to have the best chance for developing normal physical characteristics and speech patterns.

Original languageEnglish (US)
Pages (from-to)368-375
Number of pages8
JournalEar, Nose and Throat Journal
Issue number8
StatePublished - 1986

ASJC Scopus subject areas

  • Otorhinolaryngology


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