What are palatal closure operations?

Isolated Cleft Palate

Watch Dental Video about Palatal Closure Operations

Palatal closure operations are performed on patients with cleft palates.

There are many different types of cleft palates. Some patients have only an isolated bone cleft palate and a normally developed soft palate. Other patients have a complete soft and bone cleft palate. In many cases, the lips and jaw are affected along with the gums. Therefore, the various types of conditions require a wide range of the therapeutic approaches.

Treatments should always be carried out by a specialist cleft palate team made up of oral and maxillofacial surgeons, orthodontists, dentists, pediatricians, ear, nose and throat specialists, speech therapists, psychologists and human geneticists. Cooperation between these specialists, along with the care provided by the team, can help provide the patient with optimal functional and aesthetic results. The following video will now demonstrate a palate closure operation.

The aim of the palate closure operation is the closure of the cleft-related connection between the oral cavity and the nasopharynx. The closure of the cleft can occasionally lead to middle ear infections and respiratory tract infections, but eating and speaking become easier.

You can see a young patient with a cleft palate; the gum will now be closed using a two-layer technique. The operation is carried out under a general anesthetic; the mouth is kept open using special instruments so that the surgeon can concentrate on the operation at hand.

First, the nasal floor mucosa is closed; you can see how the mucosa is mobilized. The suture is then put in place and the first layer, the nasal floor, is closed. The film now demonstrates how the palatal mucosa is mobilized using the two outer incisions, allowing the gum flaps to be easily moved toward each other and then closed, tension-free, over the cleft.

The so-called outer relief incisions are placed above the healthy bone, and mucosa rapidly develops over the exposed bone. You can see that the operation is relatively quick. A multi-disciplinary team is important in order to ensure proper patient care before and after the operation.

There are no alternatives to surgery expect for leaving the palate open or using a dental plate similar to a full prosthesis for the rest of one’s life.

The risks associated with such an operation are negligible when carried out by an experienced surgeon. However, in individual cases, complications can develop which can potentially make further treatment necessary. Each additional treatment carries its own risks, which can be life-threatening. Here is a list of complications specific to palatal closure:

  • Re-opening of the soft palate
  • Wound infection
  • Paranasal sinus infections
  • Speech disorders
  • Injury of adjacent structures such as nerves, tongues, lips and their corresponding individual consequences

 

Fortunately, due to positive developments in the field of medicine over the course of the previous decades, such complications are very rare.

This post is also available in: German

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