Planning for What to Expect After Your Child’s Pharyngeal Flap Surgery

Your surgeon will lift a flap of tissue from the back of your child’s throat (oral-nasal cavity) and attach it to the back of the palate. The flap will partially close the space between the nose and the mouth so that air doesn’t escape through the nose. This helps prevent nasal speech. 

The information in this handout will help you plan for what to expect as your child recovers from this surgery. 

As with any incision, the tissue around the area will swell as it heals. The swelling might cause your child to breathe noisily or snore. This is normal and should improve as the swelling goes down. Your child will be the most swollen the day after surgery, but that will start to gradually decrease during the next several days. 

You might be able to see the some of the sutures (stitches used to close up the site where surgery was done) high in the back of the throat. They are tan or off-white and will dissolve or fall out in two to three weeks. 

You might need to use new feeding equipment or modify your child’s diet after the surgery. Because tissue was lifted from the back of the throat, children might feel pain in that area. The discomfort in their neck might make it hurt for them to swallow, so your child might become anxious when he or she is asked to eat or drink. 

You’ll receive a handout called the Full Liquid Diet when you leave the hospital. After a pharyngeal flap, your child can start drinking clear liquids (water, Pedialyte, broth, etc.) as soon as he or she is comfortable. Once your child is able to drink clear liquids, he or she can have anything to drink except acidic liquids, such as orange juice, which might burn or irritate the tissue at the back of the throat. You can then move on to full liquids. 

Your child will be on a full liquid diet for 10 to 14 days. Use a blender or food processor to puree solid foods so small bits of food don’t damage the incision. 

After two weeks, you should be able to feed your child soft foods, such as pastas and cooked vegetables and fruits, as appropriate. After two weeks of solid foods, your child’s normal diet may be resumed. Your surgeon will discuss this with you at your follow-up appointment. 

Your surgical team will give you specific recommendations before you leave the hospital, but it is likely your child won’t need any special mouth rinses. He/she should drink water after eating solid foods and might be allowed to gently brush his/her bottom teeth. Your child may be placed on an oral antibiotic following surgery.

Give your child pain-relief medicine on a regular basis the first two to three days after surgery. Have him/her take medicine before they feel discomfort, because if you wait until your child is pain, he/ she might refuse to eat or drink. If he or she has trouble taking pills, we recommend using a form of acetaminophen that dissolves. 

You need to prevent your child from rubbing or scratching the incision. 

Use your best judgment to decide when your child should return to child care. Children can usually return once they are back on a regular feeding schedule and are comfortable. Your child needs to be in an especially safe and clean environment while his or her incision is healing. 

Your nurse or doctor will give you more instructions when you leave the hospital.