Posted by Karin on 1/13/2008, 7:02 am, in reply to "palate repair"
72.205.47.145
I am not a doctor, but I understand from our ENT (mine and my son's) that there are some concerns anytime the ears, nose, throat, and related structures (like sinuses) are physiologically abornormal. Fluid drainage does not occur as nature intended it to, and the risk of infection increases. For example, when I had a deviated septum, I accumulated fluid in my sinuses and ended up with chronic (and anti-biotic resistant) infections. Also, my eustachian tubes never descended as they are supposed to in adults, and I have had chronic ear infections and fluid my entire life. In my personal experience, these issues were not problems until I was in my late 20's (and in the case of my ears, are still not a real problem, just an annoyance). But, I was cautioned by various doctors throughout my life that ignoring the physiological abnormalities could lead to such chronic infections that much more significant surgery would be required. (These doctors were the "alarmist" type. I'm sure the risk was real, but it was not the foregone conclusion that I was told it was.)
Anyway, I also know from my son's pulmonologist that an open palate is also an infection risk because of increases in aspiration when vomiting and swallowing. There is a hole that isn't supposed to be there, and fluid that passes through it can go where it isn't supposed to go.
Of course, these risks depend on how big the hole is, where it is, the control your child has over mouth muscles, other medical issues (which you said you had) ....
Again, I'm no doctor, but it seems that there are actual risks, but only you and your doctors can determine how great the risks are for your child. At 3, you do have the benefit of a bit of history to use, and maybe the risks do outweigh the benefits. If it were me, based on the issues we have seen in our family (and in myself), I would rely most heavily on the advice of our ENT to help me determine what risks lie ahead as my child aged with an open palate. Our plastic surgeon is incredible, but they don't see the chronic infections that the ENT's do.
Oh -- and I have to echo the sentiment that the earlier you do it, the easier it is on the child. My niece had her palate repaired at 9 months, and she was "recovering" for about 3 weeks. My son had his repaired at 6 months, and he appeared back to normal in only a few days. Both kids are otherwise pretty tough and resiliant, and my sister and I can only think that it was the age difference.
Sorry for such a long message -- I've been thinking about your question for a long time and thinking what I would want to know if I were you, and I ended up with diarrea of the keyboard.
--Previous Message--
: My daughter who is almost 3 has PRS
: (nonSticklers) and multiple other problems
: which probably indicate another syndrome as
: well. Due to many issues, her palate is
: still unrepaired. We spoke to her plastic
: surgeon this week. He said that the risks
: still outweigh the benefits which is
: probably true. Another thing he told us is
: that repair of the palate is 95% for speech.
: Since my daughter makes no attempts at
: speech, he feels this reduces the priority
: of repair. Does anyone know other reasons
: for repair? Has anyone else ever waited till
: much later to have the palate repaired? Any
: information would be greatly appreciated.
:
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