The palate is a structure that forms the roof of the mouth.
The palate is a structure that forms the roof of the mouth.

The palate is a structure that forms the roof of the mouth. It is divided into two separate parts, namely, the “hard palate” and “soft palate.” The hard and soft palates separate the mouth (oral cavity) from the nasal cavity.

What is the hard palate?

The hard palate makes up the front of the roof of the mouth and two-thirds of the palate. It contains the palatine bone and provides the mouth its normal structure. It is the one that allows space for the tongue to move around while speaking and chewing food.

Why is hard palate resection done?

Hard palate resection is a surgery to remove some part of the palate. It is most commonly performed for the excision of cancerous (malignant) and non-cancerous (benign) tumors of the hard palate.

Other reasons for performing hard palate resection include:

  • Alleviating the complications of a tumor that compromise the function of the oral cavity.
  • Facial reconstruction such as in cases of the eyelid, lip, and nasal deformities.

What makes you unfit for hard palate resection?

Not every patient can undergo hard palate resection. Following can make you unfit for the surgery:

  • Inability to tolerate general anesthesia
  • Extensive lesions that may require extensive surgery
  • Tumors that may be more appropriately treated with other treatments (local irradiation and/or chemotherapy)

What is done before hard palate resection?

Your doctor will ask you to stop blood-thinning medications such as aspirin and warfarin a few days before the surgery.

You will be admitted to the hospital a night prior to the surgery and will have to fast for 8-12 hours before the surgery. If you are on any medications that the doctor has advised you to continue (such as medications for diabetes), you must inform the doctor who will perform your surgery.

How is hard palate resection performed?

The doctor will administer antibiotics through your vein. They will give you general anesthesia that will make you sleep throughout the procedure.

A mouth gag is inserted to retract the tongue for a better view of the hard palate.

Next, the doctor will inject a local anesthetic into the hard palate to numb it and make the procedure less painful for you.

The affected area of the hard palate will be cut (resected). A portion of the bone may also be resected if required.

Space (defect) in the hard palate may be filled by transplanting tissue from your mouth, arm, thigh, and shoulder or from another person’s palate (donor). This tissue is known as flap, and the procedure is known as tissue reconstruction.

The wound will be cleaned and sutured.

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What happens after hard palate resection?

You will be shifted to the ward and observed for several hours after the surgery.

You will feel drowsy for several hours to 1 day while recovering from general anesthesia.

Pain will be present for at least 7-14 days after the surgery. However, it usually improves by 2 weeks following the surgery. You will be prescribed strong pain medications such as narcotic painkillers after the surgery to alleviate the pain.

It is normal to face difficulty in swallowing for a few days after the surgery. For this, you will be allowed to drink only clear liquids as tolerated on the same day or after 4-5 days (depending upon the surgery).

Make sure you have a good intake of fluids to avoid dehydration. You should be able to resume your regular diet 14 days after the surgery. During this period of recovery, avoid hard and dried foods such as nuts and chips, which can cause pain and increase your risk of bleeding.

Elevating your head by 30-45° reduces oral swelling after the surgery.

Avoid strenuous physical activity such as lifting weights and heavy workouts for 3 weeks after the surgery.

You may have chewing or taste differences after the surgery. Get such and other apprehensions, if any, cleared from your doctor.

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Medically Reviewed on 1/13/2021
References
Hard Palate Resection. Available at: https://emedicine.medscape.com/article/1890845-overview

Palate Surgery - What to Expect. Available at: https://stanfordhealthcare.org/medical-treatments/p/palate-surgery/what-to-expect.html#