Staged palate repairs were implemented to try and reduce the chance of stunting the upper jaw growth and needing to have it surgically advanced later in life, while at the same time allowing normal speech to develop. We know from several studies that the growth of the upper jaw can be stunted by operating too early on the hard palate. We also know that waiting too long to fix the palate can inhibit normal speech development. The thought of the fixing the soft palate early (the speech part of the palate) and delaying the repair of the hard palate (the growth part of the upper jaw) by anchoring a piece of plastic over the cleft was an experiment to see if the number of kids needing upper jaw surgery could be reduced. This sounds like a great idea, and has been tried by many doctors in the past, but there has not been any reproducible evidence to show that it is affective. Most centers have abandoned this practice because of this and the problems that can arise with this staged method. There are concerns that this method increases the number of surgeries a child has to undergo, possibility of speech problems with the tongue interacting with plastic instead of normal tissue, and complications that can arise with the plastic coverings coming loose or falling out.
For these reasons, the physicians at the Cleft and Craniofacial Institute of Utah feel that the best strategy for cleft palate repair is to fix the entire palate between 9-12 months of age. This is the method that is practiced by most centers in the United States and developed world. Through the many studies that have been done on this topic, closure of the entire palate between the ages of 9-12 months seems to be the best window to help develop normal speech and limit the need for upper jaw surgery later in life.