Cleft Palate Repair Follow-Up

If you had asked me a month ago how Matteo has been doing since his cleft palate repair in March, I would have told you we were expecting another surgery in the fall.  While much of his palate did heal like the doctor said it would, even after it looked like it was falling apart a week after surgery, his palate still has a sizable hole and any time he sneezed, lots of food shot out of his nose.  Then one day I realized I couldn't remember the last time I had wiped his nose and I began to have a glimmer of hope that another surgery wasn't necessarily a given. 

Last week Matteo had an appointment with the craniofacial surgeon and a craniofacial speech language pathologist at Gillette's.  The pathologist sat on the floor of her office and using toys, books, pictures and games, enticed Matteo through a series of exercises to evaluate what sounds he can and can't make.  He was a model patient in that he was eager to please and very curious.  He loved the attention and had no idea he was at therapy. 

The surgeon believed that the hole I could see in the hard palate is a fistula, which means it goes through both the oral and nasal palates, because the pathologist had observed moderate hypernasality in Matteo when he talked.  Ideally there would be no fistula, but the presentation of one isn't necessarily a problem if nothing is coming out of a child's nose and a child can speak clearly.  The fact that we have seen a significant decrease in anything coming of Matteo's nose is a very promising sign.  Of course we don't know yet how his speech will progress until we've given speech therapy some time.  Thus the surgeon wants Matteo to continue speech therapy for six months and reassess his degree of hypernasality.  If there isn't enough improvement, he will probably need the fistula repaired this winter.