Optimal timing of cleft palate closure

Treatment objectives for the cleft palate patient-normal speech, normal max illofacial growth, and normal hearing-are closely I-elated. Controversy abo ut the timing of cleft palate surgery is directed at the need for early pal atoplasty for improved speech and hearing versus delayed hard palate repair for undisturbed facial growth. This controversy as to the value of early v ersus delayed closure continues into the present. The authors present an up dated argument regarding this controversy along with a comprehensive litera ture review. They also present a logical algorithm based on the literature and their personal experience.