Cleft Palate Repair


Cleft palate repair – is surgical repair of congentinal defects in the palate

Causes of defects

1. Lack of embryonic development elements of the prepalate (face, lips, premaxilla and incisors)
2. Palate (hard or soft palate, uvula and additional maxillary teeth

  • Nursing or feeding defects
  • Speech defects
  • Respiratory defects
Time of surgery preferred:
  • Before the 2 years old
  • General anesthesia induction.
  • Insertion of endotracheal tube
  • Local anesthesia with epinephrine is injected to prevent homeostasis
  • Repair of a complete unilateral (prepalatal and palatal) defect incisions are made of the soft palate
  • Development of layers of oral mucosa, muscle and nasal mucosa
  • Suture replacement are placed on the hard palate
  • Optimal bone grafts are done
  • Two layers are sutured muscle layers and oral mucosa
Nursing Considerations in preparing the patient
  • The patient must be restrained properly since the table may be in reverse Trendelenburg position
  • Keep the patient’s temperature well regulated since the patient’s body surface area is small
  • Assist the surgeon in extending the head of the bed during the procedure
  • Always observe aseptic technique during the surgery
  • Minimize skin exposure as much as possible during the surgery
Nursing Considerations after the procedure
  • Place comfortably the patient on his or her sides
  • Use restraints on elbow level to prevent ample movement of the child
  • Hydrate the child using cups instead of bottles, as well as to clean suture lines
  • Support proper positioning by holding the child while feeding sessions to prevent aspiration.


Nursing Care Plan


Health perception and management

  • Maternal exposure to radiation or infection
  • Family member or relative with cleft lip or cleft palate

Nutrition and metabolism

  • Poor feeding
  • Difficulty sucking

Physical findings

General appearance and nutrition

  •  Visible unilateral or bilateral cleft lip
  • Underweight

Eyes, ears, nose, and throat

  • Nasal distortion


  • Visible cleft palate involving soft or hard palate with opening between the mouth and the nasal cavity
  • Impaired sucking (with cleft lip and cleft palate)