| The significant concern
during this time is the development of speech which requires good hearing. Children with
cleft palate can have poor ear drainage which may impair hearing. These children need a
hearing assessment. If the problem is significant, the child may need ear tubes.
Peer group pressure becomes an issue about the age of four years.
Therefore, it is important to have appearance restored to as near normal to avoid self esteem problems.
If the scar of lip repair is not ideal, a scar revision can be done during this period.
Occasionally, a hole or fistula can develop after the palate repair.
This may cause food and liquids to get into the nose. This hole can be repaired during this time.
Often surgeons will coordinate the surgeries so that ear tubes
and scar revision can be done a the same time in the operating room.
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