P-Flap Surgery

Henry’s series of Midface Distraction procedures successfully moved things forward to set his upper jaw more correctly in line with his lower one, but in doing so it created a new gap between his nasal and oral cavities that allowed air to pass between the two when he spoke. The result was a hypernasality that made his speech suddenly difficult to understand.

So we returned to the hospital last week for more surgery to correct this new problem. The fix was a procedure called pharyngeal flap surgery that is more commonly performed on younger patients in the event of similar speech problems after a general cleft palate repair. The “p-flap” procedure took just over two and half hours before Henry was wheeled into the post-op recovery room to be brought out of anesthesia. Once again he experienced trouble with nausea as he gradually awoke, and this seems to have established itself as a recurring problem.  After a couple of hours he was okay, and wheeled up to a regular room upstairs where we stayed until we were released to go home the next afternoon.

Henry slept through nearly the entire first day, probably due from a combination of effects from pain medication and a secondary medication aimed at reducing nausea that was introduced into his IV fluids. Once he became alert later that night we quickly started him on a steady diet of crushed popsicles and just plain crushed ice that he could keep close by in a small Styrofoam cup. This quelled a lot of the swelling around his stitched area, which was pretty far back in his throat.

By the next morning, he was dutifully performing all the requisite tasks needed for release—drinking fluids, accepting liquid oral pain meds, walking gingerly with assistance over to sit on a small couch by the window in his room. By late afternoon on the second day, we were cleared to go home.

It is several days later now and Henry is still recovering, although definitely on the mend. We’ll return for a check-up in a couple of weeks to get a full read on whether the surgery was a success. For now at least we can tell that Henry’s speech doesn’t seem to be any worse as a result and he hasn’t begun to snore during his sleep, which would be an adverse sign. Basically, he came through like a hero once more and is just happy to be returned home with a few more weeks of summer left before starting middle school.