Materiały źródłowe

• #1 Cleft lip and cleft palate – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cleft-palate/diagnosis-treatment/drc-20370990

  Surgery to repair cleft lip creates a more typical lip appearance, structure and function. Surgery is done in a way to minimize the appearance of the scar. The goals of treatment for cleft lip and cleft palate are to make it easier for a child to eat, speak and hear and achieve a typical look for the face. […] Treatment involves surgery to repair cleft lip and cleft palate and therapies to make any related conditions better. […] Surgery to correct a cleft lip and cleft palate is based on your child’s situation. Following the initial cleft repair, your healthcare professional may recommend follow-up surgeries to make speech better or make the lip and nose look better. […] Cleft lip repair between 3 and 6 months of age. Cleft palate repair by 9 to 18 months (usually around 1 year) or earlier if possible. This surgery occurs after any cleft lip repair.

• #1 Cleft Palate & Cleft Lip | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/cleft-lip-cleft-palate/

  Cleft lip is usually repaired surgically when the baby is between three to six months old. An orthodontic appliance may be used before and after the lip repair surgery to help align the lip and nose. A child with a very wide opening may need to have a temporary procedure that brings the parts of the lip closer together before the full lip repair is done. […] The goal of the surgery is to bring together the separation in the lip so that the lips work and look normal. Incisions are made on both sides of the cleft to create aps of tissue that are then drawn together and stitched to close the opening. Surgery is performed in the hospital under general anesthesia and typically takes between three and four hours. In some cases, a patient and their family will meet with an anesthesiologist in a consultation prior to the procedure.

• #1 Cleft Palate & Cleft Lip | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/cleft-lip-cleft-palate/

  A cleft palate is usually repaired between 10 and 12 months of age. The plastic surgeon carefully puts the tissue and muscles in a better position so that the opening between the nose and mouth is closed and the roof of the mouth is rebuilt. Incisions are made on both sides of the opening, and specialized ap techniques are used to reposition the muscles and the palate. The repair is then stitched closed, usually in the middle of the roof of the mouth, so that normal feeding and speech development can occur and growth can continue throughout the child’s life. Surgery for cleft palate is performed under general anesthesia. It typically takes three to four hours. In some cases, a patient and their family will meet with an anesthesiologist in a consultation prior to the procedure. […] The goal of surgery is to create a palate that works well for feeding and speech. Most children will have good speech after palate repair. If there is breakdown in the palate that does not heal in the first two months after surgery, this is called a fistula. If the fistula is felt to result in nasal leakage of air or fluids, then a fistula repair would be performed after at least six months following palate repair to be certain the tissues have adequately healed to withstand repair. Some children, however, may need further surgery on the muscles of the palate or the muscles of the throat to achieve normal speech.

• #1 Cleft lip and cleft palate – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cleft-palate/diagnosis-treatment/drc-20370990

  Cleft lip and cleft palate surgery takes place in a hospital. Your child will get medicine to go to sleep and not feel pain or be awake during surgery. Surgeons use several techniques and procedures to repair cleft lip and palate, reconstruct the affected areas, and prevent or treat related complications. […] Surgery can improve your child’s quality of life and make your child eat, breathe and talk better. Possible risks of surgery include bleeding, infection, poor healing, widening or raised scars, and short- or long-term damage to other structures. […] Your healthcare professional may recommend more treatment for other functional and structural changes that cleft lip and cleft palate cause, such as: Feeding strategies, such as using a special bottle nipple or feeder. Speech therapy to make it easier to speak. Orthodontic adjustments to the teeth and bite, such as having braces. Monitoring by a pediatric dentist for tooth development and oral health from an early age. Monitoring and treatment for ear infections, which may include ear tubes. Monitoring hearing and providing hearing aids or other devices to a child with hearing loss. Therapy with a psychologist to help the child cope with the stress of repeated medical procedures or other concerns. Regular screening and treatment for health problems is mostly limited to the first two decades of life, but lifelong monitoring may be needed depending on your child’s individual health problems.

• #1

  https://childrens.wvumedicine.org/cleft-lip-and-cleft-palate

  Some patients may need minor surgery to improve the alignment of the lip lines. The shape of the nose can also be improved with surgery. […] If a child continues having speech problems after palate repair, another surgery may be needed. A pharyngoplasty or a pharyngeal flap procedure is a procedure that can improve the function of the pharynx, which is the tissue at the back of the mouth. Only about 10 to 15 percent of children need this speech surgery. […] Some children will need an alveolar bone graft. The alveolar bone is the bone under the gums where the teeth are attached and can also have a cleft (gap). A bone graft, usually taken from the childs hip, can close this gap and provide bone for the adult teeth to go in this space. […] The team may recommend a surgery to help re-align the jaw. This might be a two-stage surgery called distraction osteogenesis for big differences or a one stage surgery called orthognathic surgery (jaw surgery) for smaller differences. […] Some children will need a rhinoplasty, or nose repair surgery, to correct the appearance, alignment, and air flow of the nose. […] At any time during your childs treatment plan, we may be able to perform small revision surgeries or touch ups to help improve self-confidence and esteem.

• #1

  https://www.shrinerschildrens.org/en/pediatric-care/cleft-palate

  The repair is completed by 1 year of age, before the childs first spoken words. […] If speech therapy alone does not help a child speak clearly, pharyngeal/soft palate surgery, typically between 3 and 6 years old, can improve the function of the soft palate which helps the child pronounce words correctly and corrects nasal-sounding speech. […] Almost every child with a cleft will need final corrective surgery after their face develops. […] The surgery in the late teenage years repositions the jaws to improve the childs bite and appearance. […] Shriners Childrens team of dentists understands these unique conditions and can coordinate care to provide the best appearance and bite when a child grows up. […] Children with cleft palate usually require a two phase treatment plan. […] Shriners Childrens team care includes evaluation by audiologists and ear, nose and throat surgeons (otolaryngologists).

• #1 Cleft Lip and Palate

  https://www.asha.org/practice-portal/clinical-topics/cleft-lip-and-palate/?srsltid=AfmBOooe1DaFyzVQFM_8Gy5hM8ldMF_PnNhIVCie55v_JU2Dw1TymL44

  Treatment for children with clefts, other craniofacial conditions, and even noncleft velopharyngeal insufficiency (VPI) is best done through a cleft palatecraniofacial team. The team typically includes a patient care coordinator, nurse, or social worker who facilitates team function and efficiency, assists families, and coordinates care for individuals and families. Based on standards developed by the American Cleft Palate Craniofacial Association (ACPA, 2022), a cleft palate team must have, as a minimum, a surgeon, an orthodontist, and an SLP. […] Comprehensive teams may also include or have access to professionals in other fields, such as audiology, otolaryngology, ophthalmology, dentistry, genetics, nursing, psychology, and social work. Others may include oral maxillofacial surgeons, developmental pediatricians, geneticists, and plastic and craniofacial surgeons. Additional members vary depending on the individuals developmental, medical, and psychological needs. See Standards for Approval of Cleft Palate and Craniofacial Teams [PDF] (ACPA, 2022) for essential characteristics of quality for team composition and functioning.

• #1 Cleft lip and cleft palate – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cleft-palate/care-at-mayo-clinic/mac-20370996

  Extensive experience. Each year, Mayo Clinic specialists treat more than 260 children who have cleft lip and cleft palate, including the most complex cases. […] Team approach. Mayo’s team at the Cleft and Craniofacial Clinic in Minnesota includes experts from various specialties based on your child’s needs. Plastic surgeons direct the team, which may include specialists in ear, nose and throat (ENT) and oral surgery, orthodontics, speech, hearing, psychology, genetics, social services, and others. […] Specialized treatment plan. The Cleft and Craniofacial Clinic studies your child’s condition. Then the team members meet to talk about their findings and create a personalized treatment plan for your child. […] Integrated expertise. Experts from many specialty areas may be part of your team. The Cleft and Craniofacial Clinic provides integrated case management to assure quality, continuity of care and long-term follow-up.

• #1 Speech-Language Therapy for Children With Cleft Palate (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/speech-therapy-cleft-palate.html

  Speech-language therapy is care that helps kids: improve speech, understand and use language, communicate in nonverbal ways (listening, taking turns, etc.) […] Speech-language pathologists help kids with speech disorders (like stuttering), hearing problems, feeding problems, and other medical conditions, including cleft palate. […] SLPs who work with children with cleft palate have extra training to recognize and treat specific problems caused by a cleft palate. Children born with a cleft palate may need speech-language therapy to help with problems such as: […] The main goals to help children with „cleft palate speech” are to: Establish correct articulation (placement, manner, and voicing) using articulation therapy techniques. Ensure there is good oral pressure during speech sound production. Establish new motor speech patterns that replace speech sound errors.

• #1 Speech-Language Therapy for Children With Cleft Palate (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/speech-therapy-cleft-palate.html

  Speech therapy should begin as soon as possible. Children who start speech therapy early tend to have greater success. […] Support from parents is key to the success of a child’s progress in speech therapy. […] Your therapist should give homework for you and your child to do after each session. Helping your child complete these activities will ensure continued progress and carryover of new skills. […] The process of overcoming a speech or language disorder can take some time and effort. So it’s important that all family members be patient and understanding. […] The American Cleft Palate-Craniofacial Association (ACPA) lists cleft teams by state on their website. To be accredited by the ACPA, each team must have a speech-language pathologist on staff.

• #1 Cleft Lip and Palate

  https://www.asha.org/practice-portal/clinical-topics/cleft-lip-and-palate/?srsltid=AfmBOooe1DaFyzVQFM_8Gy5hM8ldMF_PnNhIVCie55v_JU2Dw1TymL44

  Direct speech therapy is appropriate for treatable articulation disorders, including compensatory misarticulations and phoneme-specific nasal air emission due to a pharyngeal placement on sibilants. […] The objectives of therapy are to correct abnormal placements for consonant misarticulations (e.g., bring backed oral articulations forward, teach correct oral place, and establish oral pressure buildup and release) and establish oral pathway/direction of airflow and appropriate valving of airflow at target place during production of oral sounds (Golding-Kushner, 2001; Ruscello, 2017; Trost-Cardamone, 2013). […] Therapy typically targets the elimination of compensatory misarticulations first, as these tend to have greater impact on intelligibility and VP function than do other types of speech sound errors. Later therapy addresses developmental articulation or phonological errors if present.

• #1 Cleft Lip and Palate

  https://www.asha.org/practice-portal/clinical-topics/cleft-lip-and-palate/?srsltid=AfmBOooe1DaFyzVQFM_8Gy5hM8ldMF_PnNhIVCie55v_JU2Dw1TymL44

  Treatment of children affected by clefts or other craniofacial conditions involves normalizing structure through physical management (surgical or orthodontic) and normalizing function through therapy. Treatment may also include early feeding intervention, dental care and orthodontics, audiologic care and monitoring of hearing status, and psychological services. See Parameters for Evaluation and Treatment of Patients With Cleft Lip/Palate or Other Craniofacial Differences (ACPA, 2018). […] Feeding disorders are among the first concerns following the birth of a child with cleft lip and palate. The goal of feeding intervention is to ensure adequate and efficient intake for appropriate hydration and nutrition, for growth and development, and for adequate medical status prior to surgery. […] An important additional goal is to ensure that feeding is a low-stress experience for the infant and their family (Reid, 2004). Health care providers (e.g., SLPs, nurses, or lactation consultants) instruct mothers in feeding techniques and reassure them that successful feeding can be accomplished with the least amount of stress for the infant and family (Goyal et al., 2014).

• #1 Cleft Lip & Cleft Palate: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate

  Problems with eating, hearing and speech are common in children with clefts. Children may also have issues with their teeth or self-esteem. […] With a separation or opening in the palate, food and liquids can pass from your childs mouth back through their nose. Some babies have difficulty breastfeeding or taking a bottle because they cant create enough suction. […] Children with cleft palate are more prone to fluid buildup in their middle ears (glue ear). If left untreated, this causes hearing loss. […] Children with cleft palate may have trouble speaking. Their voices may not carry well, and their speech may be difficult to understand. Not all children have these problems, and surgery may solve them. […] A note from Cleveland Clinic: Whether you learned about this condition during a prenatal ultrasound or after delivery, a cleft lip or palate can raise many concerns that may be hard to put into words. You might worry about the surgeries your baby will need, how theyll recover or what their childhood will be like. Know that your babys care team is there for everyone in your family (including you).

• #1 Cleft Lip and Palate

  https://www.asha.org/practice-portal/clinical-topics/cleft-lip-and-palate/?srsltid=AfmBOooe1DaFyzVQFM_8Gy5hM8ldMF_PnNhIVCie55v_JU2Dw1TymL44

  A number of strategies and techniques can be used to facilitate feeding success prior to surgery, including placing the baby in an upright position while feeding to help prevent nasal regurgitation; providing jaw and cheek support, as needed; using the appropriate nipple size; positioning the nipple optimally (e.g., away from the side of cleft, if unilateral); pacing the flow rate and providing fluid in rhythm with the babys cues (e.g., movements and reactions); burping frequently to counter excessive air intake; and limiting feeding time (e.g., no more than 30 minutes) to avoid fatigue (Dailey, 2013; Peterson-Falzone et al., 2010, 2016). […] Some cleft palate centers offer nasoalveolar molding (NAM) for infants with cleft lip and palate before surgery. NAM is a presurgical appliance that is used prior to surgery to align maxillary segments; however, a secondary benefit is that the appliance can function as a dental plate. Some parents report improved feeding with a NAM appliance (Zajac Vallino, 2017b).

• #1 Cleft Lip & Cleft Palate: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate

  Cleft palate surgery usually occurs when your baby is 12 months old. It creates a working palate and reduces the chances that fluid will develop in your babys middle ears. […] Up to 40% of children with a cleft palate will need further surgeries to help improve their speech. […] Children often need treatment beyond surgery for cleft lip or palate. Some other treatments their healthcare providers may recommend are speech therapy and orthodontic treatment. […] Because of the number of oral health and medical problems associated with a cleft lip or cleft palate, it takes a team of healthcare providers working together to develop a comprehensive care plan. Your childs treatment usually begins in infancy and often continues through their early adulthood. […] Generally, children with clefts have the same dental needs as other children. However, children with cleft lip and palate may also have missing, misshapen or poorly positioned teeth.

• #1

  https://childrens.wvumedicine.org/cleft-lip-and-cleft-palate

  The repair of a cleft lip or palate is a process. Each phase of treatment builds on the treatment before. We monitor your childs progress continually. We address complications if they arise and keep you informed at every stage. […] Treatment usually beings with some form of nonsurgical molding. This is either nasoalveolar molding (NAM) or lip taping in the first few weeks after birth. This treatment uses tape or a dental plate to reduce the size of the cleft by bringing together the two sections of skin and muscle. This can be a helpful tool in cleft care but is not absolutely necessary. […] Typically, children with cleft lip will usually have this repaired around five to six months of age. A second repair surgery for the cleft palate will usually be performed between 10 and 12 months of age before speech begins.

• #1 Pediatric Cleft Lip and Palate Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/995535-treatment

  The most common surgical procedures for a child with a CLP anomaly are as follows: Repair of the CL, Repair of the CP, Revision of the CL, Closure and bone grafting of the alveolar cleft, Closure of palatal fistulae, Palatal lengthening, Pharyngeal flap, Pharyngoplasty, Columellar lengthening, CL rhinoplasty and septoplasty, Lip scar revision, LeFort I maxillary osteotomy. […] Orthodontic treatment is highly specialized and varies from case to case. […] There has been considerable enthusiasm for employing presurgical infant orthopedics (PSIO) in CLP patients to improve surgical outcomes with minimal intervention. […] Their review suggested that NAM does not alter skeletal facial growth but found evidence of benefits to patients, caregivers, surgeons, and society, including the following: Documented reduction in the severity of the cleft deformity before surgery and, as a consequence, improved surgical outcomes, Reduced burden of care on caregivers, Reduction in the need for revision surgery, Consequent reduced overall cost of care to patient and society. […] Gaining weight and preventing aspiration and ear infections are the most important parts of caring for neonates with a cleft during their first days and weeks of life.

• #1 Cleft Palate Repair Treatment & Management: Medical Therapy, Surgical Therapy, Follow-up

  https://emedicine.medscape.com/article/1279283-treatment

  Medical Therapy […] The Pierre Robin sequence is classically associated with retrognathia, glossoptosis, respiratory distress, and a cleft palate. If untreated, death may result from obstruction by the tongue, which has fallen back in the airway. The most appropriate first step in management is to place the infant in the prone position to allow the tongue to fall forward and clear the trachea. […] Many types of orthodontic appliances have been used in the treatment of patients with cleft palate. In cleft lip/palate, orthodontic appliances can be used to realign the premaxilla into a normal position prior to lip closure. Orthodontic interventions in patients with cleft palate are frequently aimed at maxillary arch expansion, correction of malocclusion, and correction of an often developing class III skeletal growth pattern. The maxillary dental arch contracture may become significant, requiring the surgical repair of the hard palate. Orthodontic interventions may be started early or delayed for several years. When orthodontic manipulation is initiated early, difficulties may occur. Maintaining orthodontic appliances in the infant population may present a challenge unless these appliances are fixed in position. […] The most beneficial period for orthodontic interventions in isolated cleft palate may be during the mixed dentition period. […] At approximately age 6-8 years, the permanent incisors are erupting. During this period, children are beginning to have social interactions with their peers. The presence of grossly malaligned teeth and severe malocclusion can lead to social isolation. The incisor relation can be corrected and maintained with relatively simple interventions. Patients who undergo palatal arch expansion therapy during this period can benefit from the rapid growth phase. The orthodontic intervention can also proceed with more cooperation from the patient in this age group. Orthodontic management of arch deformities after the permanent dentition has erupted is more limited. The established malocclusion and asymmetry between the maxillary arch and mandibular arch usually require orthognathic surgery.

• #1

  https://www.nhs.uk/conditions/cleft-lip-and-palate/

  Cleft lip and cleft palate are treated at specialist NHS cleft centres. […] Your child will usually have a long-term care plan that outlines the treatments and assessments they’ll need as they grow up. […] The main treatments are: surgery an operation to correct a cleft lip is usually done when your baby is 3 to 6 months and an operation to repair a cleft palate is usually done at 6 to 12 months […] feeding support you may need advice about positioning your baby on your breast to help them feed, or you might need to feed them using a special type of bottle […] monitoring hearing a baby born with cleft palate has a higher chance of glue ear, which may affect hearing. Close monitoring of their hearing is important and if glue ear affects their hearing significantly, a hearing aid may be fitted or small tubes called grommets may be placed in their ears to drain the fluid

• #1

  https://childrens.wvumedicine.org/cleft-lip-and-cleft-palate

  It is common for children with cleft palate to have a procedure to insert ear tubes in the middle ear. These tubes help drain fluid to improve hearing and prevent infection. […] Children and families should establish a dental home with a pediatric dentist by the end of the first year. This ensures children get complete oral care throughout their cleft lip and palate treatment. Good dental hygiene is critical in the treatment of cleft. […] A speech therapist will closely monitor your childs development to spot signs of impairment. Regular checkups with a pediatric dentist can help address common dental problems, such as missing teeth, extra teeth, or cavities. […] If a child continues having speech problems after palate repair, another surgery may be needed. A palatal lengthening, pharyngoplasty or a pharyngeal flap procedure is a procedure that can improve the function of the pharynx. Only about 10 to 15 percent of children need this speech surgery.

• #1 Cleft Lip & Palate | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/cleft-lip-and-palate/

  Tympanotomy surgery creates a small opening for placement of an ear tube. Approximately 90% of children with cleft palate will require tympanotomy and ear tube(s). […] Additional cleft lip and palate surgeries include: Speech surgeries, Cleft lip and/or palate revision(s), Nasal surgery, Bone grafting, Jaw surgery. […] For over 45 years, Children’s Colorado has been a top treatment center in the country for children with cleft lip and palate. […] Our multidisciplinary team and exceptional outcomes have earned us the American Cleft Palate-Craniofacial Association endorsement.

• #1 Supportive Treatment for a Cleft Lip or Palate

  http://healthlibrary.chnola.org/Library/PreventionGuidelines/3,89827

  Help your child cope with social and emotional issues. Explain to your child that other children tend to react poorly to differences. Reassure your child that they have done nothing wrong. […] Give your child a lot of positive feedback about their appearance. This will boost your childs self-esteem. Positive messages from loved ones also help your child face other peoples insensitive words and actions. […] Talk with your child’s teachers about your child’s cleft lip or palate. Ask the teacher what they can do in the classroom to help other children understand cleft lip or palate. If your child is old enough, ask your child how they would like the classroom situation managed. This will help ensure that your child has support in the classroom.

• #1 Pediatric Cleft Lip and Palate Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/995535-treatment

  Because otitis media with effusion is very common among children with CP, involvement of an otolaryngologist in the multidisciplinary treatment plan is of great importance. The otolaryngologist performs placement of ventilation tubes in conjunction with the CP repair. […] A team for the multidisciplinary treatment of a child with an orofacial cleft includes the following specialists: Pediatrician, Nurse practitioner, Plastic surgeon, Pediatric dentist, Otolaryngologist, Geneticist, Genetic counselor, Speech pathologist, Orthodontist, Maxillofacial surgeon, Social worker, Psychologist. […] No single treatment concept has been identified, especially for CLP. The timing of the individual procedures varies in different centers and with different specialists. […] The following is the most common treatment protocol currently used in most cleft treatment centers: Newborn – Diagnostic examination, general counseling of parents, feeding instructions, palatal obturator (if necessary); genetic evaluation and specification of diagnosis; empiric risk of recurrence of cleft calculated; recommendation of a protocol for the prevention of a cleft recurrence in the family.

• #1 Cleft Lip and Cleft Palate | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/cleft-lip-and-cleft-palate

  Yes. The opening in the hard and/or soft palate is usually closed in one operation, though your child may need more than one procedure depending on his particular circumstances. Your treatment team will outline specific recommendations. […] Treatment for a cleft lip/cleft palate usually involves reconstructive surgery and several key support services. […] The Cleft Lip and Palate Program at Boston Children’s Hospital takes a multidisciplinary team approach to repairing your child’s specific cleft and addressing related conditions. […] A cleft palate is typically closed between the ages of 9 and 11 months, before a baby makes their first attempt to use words. Your child’s plastic surgeon will discuss the best repair plan for their needs and circumstances. […] Approximately five to 15 percent of all children who have undergone a cleft palate repair will need a second operation to correct nasal-sounding speech. These operations are often performed around 4 to 6 years old. A common procedure is called a pharyngeal flap, but other operations may be recommended based on your child’s anatomy.

• #1 Cleft palate and cleft lip | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cleft-palate-and-cleft-lip

  Depending on the location and severity of the cleft, other treatments might include: follow-up surgery on the hard palate at a later stage, jawbone realignment prior to surgery, using elastic braces, bone grafts for the upper jaw at around 10 years of age, ongoing dental and orthodontic care, rhinoplasty surgery to improve breathing and nasal symmetry, subsequent revision surgery this may be necessary as your child matures. […] Your child may need some or all of these treatments, depending on their condition. However, location and severity are just part of the picture. Treatment needs and success will depend on a range of factors. A severe cleft does not always need complex treatment.

• #1 Cleft lip and cleft palate – Wikipedia

  https://en.wikipedia.org/wiki/Cleft_lip_and_cleft_palate

  Cleft lip and palate is very treatable; however, the kind of treatment depends on the type and severity of the cleft. […] Most children with a form of clefting are monitored by a cleft palate team or craniofacial team through young adulthood. Care can be lifelong and are looked after by craniofacial cleft teams often consist of: cleft surgeons, orthodontists, speech and language therapists, restorative dentists, psychologists, ENT surgeons and audio-logical physicians. Treatment procedures can vary between craniofacial teams. For example, some teams wait on jaw correction until the child is aged 10 to 12, while other teams correct the jaw earlier. […] Within the first 23 months after birth, surgery is performed to close the cleft lip. While surgery to repair a cleft lip can be performed soon after birth, often the preferred age is at approximately 10 weeks of age, following the „rule of 10s.” If the cleft is bilateral and extensive, two surgeries may be required to close the cleft, one side first, and the second side a few weeks later. The most common procedure to repair a cleft lip is the Millard procedure.

• #1 Cleft Lip and Palate Diagnosis, Causes, Treatment | National Institute of Dental and Craniofacial Research

  https://www.nidcr.nih.gov/health-info/cleft-lip-palate

  Treatment for children with cleft lip or palate depends on the size of the cleft, the child’s age and needs, and whether there are additional problems related to a genetic syndrome. A child with cleft lip or palate is often referred to a team of experts that may include an otolaryngologist (ear, nose, and throat doctor), plastic surgeon, oral surgeon, speech pathologist, pediatric dentist, orthodontist, audiologist, pediatrician, nutritionist, and psychologist/social worker. […] Surgery is often used to close the lip and palate. Cleft lip surgery is usually done before a baby’s first birthday, and cleft palate surgery is done before 18 months. If there are other problems as they get older, a child may need additional surgeries, dental and orthodontic care, and speech therapy. With treatment, most children with cleft lip or palate do well and lead a healthy life.

• #1 Cleft Lip & Cleft Palate Surgery: Repair Steps & Post-op Care

  https://my.clevelandclinic.org/health/treatments/23394-cleft-lip-cleft-palate-surgery

  Cleft lip and cleft palate surgery help restore function to your childs lips and mouth and correct their appearance. Surgery helps improve your childs ability to eat and drink, breathe, hear, and speak. […] Surgery to fix cleft lip typically occurs when a child is 3 to 6 months old. Cleft palate surgery generally occurs when a child is around 12 months old (before your child learns to talk). […] Several healthcare providers are involved in your childs care, including surgeons, speech therapists, otolaryngologists (head and neck surgeons) and dentists. Your childs surgeon will meet with you to evaluate your childs cleft palate or cleft lip and determine the best surgical treatment. […] The goal of cleft lip surgery is to close the gap in your childs lip and improve the shape and appearance of their upper lip and nose. Cleft palate surgery aims to close the opening in the roof of your childs mouth, create a palate that supports normal speech development and prevent food from coming out of their nose.

• #1 Cleft Lip and Palate Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/cleft-lip-and-palate-program

  Our center cares for a large number of patients and performs the highest volume of cleft-related operations in New England every year. We treat an average of 967 children with cleft lip and palate each year, ranging from infancy to young adulthood. […] Because we constantly strive for improvement, in 2016, our center began prospectively tracking our cleft outcomes. We regularly evaluate the quality of our treatment to ensure we provide our patients the best care possible. We take pride in our low complication rates. Our long-term outcomes are comparable to or better than many other leading cleft centers, and we continually work to improve the care we provide. […] Here at Boston Children’s, our compassionate clinicians also understand the emotional and psychosocial toll cleft lip and cleft palate can cause. We recognize your child as an individual never just a patient and provide vital resources and support to meet the needs of your entire family. We also regularly measure our patients’ quality of life using the CLEFT-Q scale and other patient and parent-reported surveys.

• #1 Cleft Palate & Cleft Lip | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/cleft-lip-cleft-palate/

  Routine post-operation care will be with a plastic surgeon on a frequent basis. After the second year of life, the patient will have annual visits to the multidisciplinary cleft team clinic. […] Additional surgeries are dependent on the severity of clefting at birth, dental needs and patient growth. Some children may require a few surgical procedures at various ages to achieve their best outcome. Timeline of these surgeries are dependent on many factors, which are discussed in detail during appointments with the providers of the cleft team. […] Due to a newborn’s outstanding healing abilities, the results of the surgery are excellent both aesthetically and functionally. Children born with this condition have an outstanding quality of life and a normal life expectancy.

• #1 Cleft Lip and Palate: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/oral-health/cleft-lip-cleft-palate

  Other surgeries improve the look of the lip and nose, close openings between the mouth and nose, help with breathing, and straighten the jaws and teeth. Some children will not have their last surgery until the teen years once their face has grown. […] Your child’s doctor may suggest one or more of these treatments to fix complications from a cleft lip and palate: braces to straighten the teeth, ear tubes and other treatments for ear infections, feeding therapy, hearing aids, speech therapy, talk therapy to manage the stress of living with cleft lip and palate. […] Treatment for a cleft lip and cleft palate can take many years and involve several surgeries. But most children with this condition can have a normal childhood and life.

• #2 Cleft Lip & Cleft Palate: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate

  Cleft lip and cleft palate are separations in the upper lip and mouth that occur while a fetus develops in the uterus. Treating cleft lip and palate involves surgery and may include speech therapy and dental work. Your childs medical care team is there to support you each step of the way. […] Surgery can repair a cleft lip and/or cleft palate. […] Treatment for cleft lip and cleft palate begins at birth. Surgical treatment begins as early as 3 months and can last until the teen years. […] Surgery treats cleft lip and/or cleft palate. The exact details of treatment depend on the extent of the cleft, your childs age and other special needs or health conditions. Your child will have surgery at a hospital, under general anesthesia, so theyll be asleep during the procedure. […] A cleft lip repair may require one or two surgeries. The first surgery usually occurs when your baby is between 3 and 6 months old. This surgery closes their lip. The second surgery, if necessary, is usually done when your child is 6 months old.

• #2 Cleft Lip & Cleft Palate Surgery: Repair Steps & Post-op Care

  https://my.clevelandclinic.org/health/treatments/23394-cleft-lip-cleft-palate-surgery

  Cleft lip and cleft palate surgery repair your childs upper lip and palate (roof of their mouth). Surgery begins at three months old and may continue through the teenage years. […] Cleft lip and cleft palate are separations, or splits, in the lip and mouth of an infant. A cleft occurs when tissues dont join together properly during fetal development. […] Cleft lip repair is surgery to fix a split (cleft) in your childs lip. Their surgeon makes a cut (incision) along the edges of the cleft lip extending up into their nose. They use stitches to reapproximate the muscle of your childs upper lip and bring the cut edges of the skin together to shape the upper lip and nostrils. […] Cleft palate repair is surgery to fix a separation or opening in the roof of your childs mouth. Their surgeon detaches and rearranges the tissues on the roof of their mouth. Stitches are used to bring the left and right sides of the cleft together.

• #2 Cleft Palate & Cleft Lip | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/cleft-lip-cleft-palate/

  A cleft palate is usually repaired between 10 and 12 months of age. The plastic surgeon carefully puts the tissue and muscles in a better position so that the opening between the nose and mouth is closed and the roof of the mouth is rebuilt. Incisions are made on both sides of the opening, and specialized ap techniques are used to reposition the muscles and the palate. The repair is then stitched closed, usually in the middle of the roof of the mouth, so that normal feeding and speech development can occur and growth can continue throughout the child’s life. Surgery for cleft palate is performed under general anesthesia. It typically takes three to four hours. In some cases, a patient and their family will meet with an anesthesiologist in a consultation prior to the procedure. […] The goal of surgery is to create a palate that works well for feeding and speech. Most children will have good speech after palate repair. If there is breakdown in the palate that does not heal in the first two months after surgery, this is called a fistula. If the fistula is felt to result in nasal leakage of air or fluids, then a fistula repair would be performed after at least six months following palate repair to be certain the tissues have adequately healed to withstand repair. Some children, however, may need further surgery on the muscles of the palate or the muscles of the throat to achieve normal speech.

• #2 Cleft Lip & Cleft Palate: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate

  Cleft palate surgery usually occurs when your baby is 12 months old. It creates a working palate and reduces the chances that fluid will develop in your babys middle ears. […] Up to 40% of children with a cleft palate will need further surgeries to help improve their speech. […] Children often need treatment beyond surgery for cleft lip or palate. Some other treatments their healthcare providers may recommend are speech therapy and orthodontic treatment. […] Because of the number of oral health and medical problems associated with a cleft lip or cleft palate, it takes a team of healthcare providers working together to develop a comprehensive care plan. Your childs treatment usually begins in infancy and often continues through their early adulthood. […] Generally, children with clefts have the same dental needs as other children. However, children with cleft lip and palate may also have missing, misshapen or poorly positioned teeth.

• #2

  https://med.uth.edu/txcleft/treatments/cleft-lip-and-cleft-palate/

  Cleft Palate repair is a longer procedure than repair of the lip and requires a 2 to 3 day hospital stay. This is because post operative swelling can block your child’s airway and so we can ensure your child gets enough fluids until he or she begins drinking after surgery. […] Most children with cleft lip and/or palate develop normal speech once their palate is closed. According to the Cleft Palate Foundation 20-25% will need further surgery, speech therapy or a prosthetic speech aid to improve their speech. […] We recommend children born with clefts be referred for Early Childhood Intervention (ECI) programs. […] Children with cleft lip/palate will need the services of a Speech/Language Pathologist from early infancy throughout their childhood years. Some will need occasional evaluation and monitoring while others will need help with oral motor development and feeding as well as yearly evaluations and ongoing speech and language therapy.

• #2 Cleft Lip and Palate Clinic Conditions We Treat | Texas Children’s

  https://www.texaschildrens.org/departments/cleft-lip-and-palate-clinic/conditions-we-treat

  Surgical repair of the cleft lip is usually performed in the first 3-6 months of life. […] Doctors usually recommend cleft palate repair when the child is 9 -12 months old. […] The cleft palate operation is a functional: its goal is to repair the hole in the palate as well as the muscles in the palate so that appropriate speech production can be achieved. After this repair, constant speech therapy is needed so that any speech problems can be identified early and addressed. […] After the cleft lip and palate have been repaired, each patient is followed by the Cleft Lip and Palate Clinic on to make sure all issues associated with the cleft have been addressed. […] Further surgical intervention is not necessary until the permanent teeth begin to replace the baby teeth. […] After alveolar bone grafting is done, the craniofacial orthodontist will work to straighten all of the teeth.

• #2 Pediatric Cleft Lip and Palate Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/995535-treatment

  Age 3 months – Repair of CL (and placement of ventilation tubes). […] Age 6 months – Presurgical orthodontics, if necessary; first speech evaluation. […] Age 9 months – Speech therapy begins. […] Age 9-12 months – Repair of CP (placement of ventilation tubes if not done at the time of CL repair). […] Age 1-7 years – Orthodontic treatment. […] Age 7-8 years – Alveolar bone graft. […] Older than 8 years – Orthodontic treatment continues. […] Other surgical procedures can be performed in patients with severe clefts as necessary. […] Pediatricians used to strictly follow a rule of „three 10s” as a necessary requirement for identifying the child’s status as suitable for surgery (ie, weight 10 lb [4.5 kg], hemoglobin 10 g/dL, and age 10 wk). […] Anatomic differences predispose children with CLP and those with isolated CP to ear infections. For this reason, ventilation tubes are placed to ventilate the middle ear and prevent hearing loss secondary to otitis media with effusion.

• #2 Cleft lip and cleft palate – Wikipedia

  https://en.wikipedia.org/wiki/Cleft_lip_and_cleft_palate

  There are different options on how to feed a baby with cleft lip or cleft palate which include: breast-feeding, bottle feeding, spoon feeding and syringe feeding. Although breast-feeding is challenging, it improves weight-gain compared to spoon-feeding. Nasal regurgitation is common due to the open space between the oral cavity and the nasal cavity. […] Each person’s treatment schedule is individualized. The table below shows a common sample treatment schedule. The colored squares indicate the average timeframe in which the indicated procedure occurs. In most cases of cleft lip and palate that involve the alveolar bone, patients will need a treatment plan including the prevention of cavities, orthodontics, alveolar bone grafting, and possibly jaw surgery. […] People with CLP present with a multiplicity of problems. Therefore, effective management of CLP involves a wide range of specialists. The current model for delivery of this care is the multidisciplinary cleft team. This is a group of individuals from different specialist backgrounds who work closely together to provide patients with comprehensive care from birth through adolescence.

• #2 Pediatric Cleft Lip and Palate Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/995535-treatment

  Because otitis media with effusion is very common among children with CP, involvement of an otolaryngologist in the multidisciplinary treatment plan is of great importance. The otolaryngologist performs placement of ventilation tubes in conjunction with the CP repair. […] A team for the multidisciplinary treatment of a child with an orofacial cleft includes the following specialists: Pediatrician, Nurse practitioner, Plastic surgeon, Pediatric dentist, Otolaryngologist, Geneticist, Genetic counselor, Speech pathologist, Orthodontist, Maxillofacial surgeon, Social worker, Psychologist. […] No single treatment concept has been identified, especially for CLP. The timing of the individual procedures varies in different centers and with different specialists. […] The following is the most common treatment protocol currently used in most cleft treatment centers: Newborn – Diagnostic examination, general counseling of parents, feeding instructions, palatal obturator (if necessary); genetic evaluation and specification of diagnosis; empiric risk of recurrence of cleft calculated; recommendation of a protocol for the prevention of a cleft recurrence in the family.

• #2 Cleft Lip and Palate Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/cleft-lip-and-palate-program

  Our center cares for a large number of patients and performs the highest volume of cleft-related operations in New England every year. We treat an average of 967 children with cleft lip and palate each year, ranging from infancy to young adulthood. […] Because we constantly strive for improvement, in 2016, our center began prospectively tracking our cleft outcomes. We regularly evaluate the quality of our treatment to ensure we provide our patients the best care possible. We take pride in our low complication rates. Our long-term outcomes are comparable to or better than many other leading cleft centers, and we continually work to improve the care we provide. […] Here at Boston Children’s, our compassionate clinicians also understand the emotional and psychosocial toll cleft lip and cleft palate can cause. We recognize your child as an individual never just a patient and provide vital resources and support to meet the needs of your entire family. We also regularly measure our patients’ quality of life using the CLEFT-Q scale and other patient and parent-reported surveys.

• #2 Cleft Lip and Palate

  https://www.asha.org/practice-portal/clinical-topics/cleft-lip-and-palate/?srsltid=AfmBOooe1DaFyzVQFM_8Gy5hM8ldMF_PnNhIVCie55v_JU2Dw1TymL44

  Direct speech therapy is appropriate for treatable articulation disorders, including compensatory misarticulations and phoneme-specific nasal air emission due to a pharyngeal placement on sibilants. […] The objectives of therapy are to correct abnormal placements for consonant misarticulations (e.g., bring backed oral articulations forward, teach correct oral place, and establish oral pressure buildup and release) and establish oral pathway/direction of airflow and appropriate valving of airflow at target place during production of oral sounds (Golding-Kushner, 2001; Ruscello, 2017; Trost-Cardamone, 2013). […] Therapy typically targets the elimination of compensatory misarticulations first, as these tend to have greater impact on intelligibility and VP function than do other types of speech sound errors. Later therapy addresses developmental articulation or phonological errors if present.

• #2 Speech Therapy for Children with Cleft Lip or Cleft Palate

  https://www.betterspeech.com/post/speech-therapy-cleft-palate

  […] […] Speech therapy can help children with cleft lip and palate in many ways. Here are just a few: […] 1. For articulation, speech therapists can help children with cleft lip and palate. They will help them learn how to make all the sounds needed for speech. […] 2. For resonation, speech therapists can help children learn how to resonate speech sounds. This can be done by using their nose and mouth. With activities such as blow bubbles and straw phonation, children can learn how to produce speech sounds correctly. […] 3. For feeding, speech therapists can help children with feeding difficulties. It might be caused by cleft lip and palate. Children with cleft lip may have problems with lip closure that causes spillage when drinking from a cup. Therapists can help children learn how to correct this by using different cups and straws.

• #2 Cleft Lip and Palate Program | Oral Health | Loyola Medicine

  https://www.loyolamedicine.org/services/oral-health-dental-and-maxillofacial-surgery/cleft-lip-and-palate-program

  Loyola Medicine is one of the only centers in the Chicago area and around the country currently offering nasoalveolar molding (NAM), a pre-surgical technique that reshapes the gums, lip and nostrils in a baby who has a large cleft. When your baby is a few weeks old, he or she is fitted with a custom plate that molds the structures of the face. In a few weeks, this painless technique reduces the number and complexity of surgeries a child needs to correct a cleft in his or her lifetime. […] Because cleft lip and palate can be accompanied by other deformities and functional problems, secondary surgeries and treatments may be needed to help the child either before or after the main surgery. These may include: […] Your childs doctor will tailor a plan for his or her unique needs and will weigh the options with you. In addition to providing comprehensive treatment to improve your childs quality of life, our goal is to provide education and support for your child and your family through diagnosis, treatment and recovery.

• #2 Supportive Treatment for a Cleft Lip or Palate

  http://healthlibrary.chnola.org/Library/PreventionGuidelines/3,89827

  Be sure your child wears any prescribed spacers or guards as instructed. They help with normal mouth function. Your child will likely need to wear these dental appliances for the rest of their life. […] Cleft palate that affects the gum often causes teeth to grow in abnormally. Your child will likely need braces to straighten the teeth. Braces can be used to fix baby or adult teeth. Your child may also need to have their jaw fixed or have missing teeth replaced. […] Follow up with the pediatric dentist and orthodontist. Your child will need regular mouth care for the rest of their life. […] Your child will likely begin speech therapy before surgery to repair the cleft lip or cleft palate. Therapy will continue after surgery. The speech pathologist will help your child relearn where to place the tongue, how to say words, and how to swallow, if needed. Expect your child to work with a speech pathologist until your child can speak well. Many children with cleft lip, cleft palate, or both, develop normal speech at about age 6 or 7 years old. But it varies, depending on the child and how severe the cleft was.

• #2 Cleft Lip and Cleft Palate Surgery | Duke Health

  https://www.dukehealth.org/pediatric-treatments/pediatric-plastic-and-reconstructive-surgery/cleft-lip-and-cleft-palate

  Nasoalveolar molding (NAM) is a pre-surgical, custom-made orthopedic appliance that brings together the two sides of a cleft lip or palate and narrows a wide cleft. Our expertise with the NAM device ensures your child experiences the best possible results. NAM can also reduce or eliminate the need for additional surgical procedures. […] When a cleft lip is present, it is important to evaluate whether nasoalveolar molding (NAM) is appropriate for your baby and start the process early. […] We provide ongoing care for children as they grow into their teen years. If kids have been with our team from infancy, we typically see them annually with the entire team to make sure they meet milestones and receive medical and surgical intervention as they grow. […] The pre-surgical, custom-made orthopedic appliance narrows a wide cleft by bringing together the two sides of the cleft lip and gum while molding the distorted nose. This facilitates the primary lip, nose, and gum surgery, and results in a more aesthetic outcome.

• #2 Cleft Lip and Palate Repair Surgery | Children’s Hospital of Philadelphia

  https://www.chop.edu/treatments/surgical-repair-cleft-lip-and-palate

  Surgical repair of cleft palate separates the oral and nasal cavities. This separation involves the formation of a watertight and airtight valve that is necessary for normal speech. The repair also helps with preserving facial growth and proper dental development. […] Once the lip and palate are repaired, typically no further surgery is performed for several years. A portion of the palate is usually left open to allow room for the mouth, palate and jaw to grow. […] Alveolar bone grafting creates a more complete dental arch, and space for permanent teeth to erupt, by placing bone along the alveolus where it is deficient. […] If the patient has a significant nasal deformity, an intermediate rhinoplasty may be performed. […] Orthodontic treatment may consist of several phases of treatment, lasting several years each. […] Cleft palate patients commonly have underdevelopment of the maxilla (upper jaw), resulting in maxillary retrusion. […] The goal of treatment is to complete all procedures by the time a patient reaches skeletal maturity (usually around age 18).

• #2 Cleft Lip & Cleft Palate: Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10947-cleft-lip-cleft-palate

  Problems with eating, hearing and speech are common in children with clefts. Children may also have issues with their teeth or self-esteem. […] With a separation or opening in the palate, food and liquids can pass from your childs mouth back through their nose. Some babies have difficulty breastfeeding or taking a bottle because they cant create enough suction. […] Children with cleft palate are more prone to fluid buildup in their middle ears (glue ear). If left untreated, this causes hearing loss. […] Children with cleft palate may have trouble speaking. Their voices may not carry well, and their speech may be difficult to understand. Not all children have these problems, and surgery may solve them. […] A note from Cleveland Clinic: Whether you learned about this condition during a prenatal ultrasound or after delivery, a cleft lip or palate can raise many concerns that may be hard to put into words. You might worry about the surgeries your baby will need, how theyll recover or what their childhood will be like. Know that your babys care team is there for everyone in your family (including you).

• #2

  https://www.shrinerschildrens.org/en/pediatric-care/cleft-palate

  The repair is completed by 1 year of age, before the childs first spoken words. […] If speech therapy alone does not help a child speak clearly, pharyngeal/soft palate surgery, typically between 3 and 6 years old, can improve the function of the soft palate which helps the child pronounce words correctly and corrects nasal-sounding speech. […] Almost every child with a cleft will need final corrective surgery after their face develops. […] The surgery in the late teenage years repositions the jaws to improve the childs bite and appearance. […] Shriners Childrens team of dentists understands these unique conditions and can coordinate care to provide the best appearance and bite when a child grows up. […] Children with cleft palate usually require a two phase treatment plan. […] Shriners Childrens team care includes evaluation by audiologists and ear, nose and throat surgeons (otolaryngologists).

• #2 Cleft Lip and Cleft Palate

  https://www.asha.org/public/speech/disorders/cleftlip/?srsltid=AfmBOop9YYXKHF3Qu2nO5L-HUU3aNqVb-OZ4bWkyb6iJ3hRVmWqm6Yyo

  A child with a cleft lip or palate can have feeding and speech problems. Speech-language pathologists, or SLPs, can help. […] Treatment for Cleft Lip and Palate […] Although cleft lip palate is often addressed with surgery and dental and orthodontic care, the medical team supports any additional feeding, speech, or hearing problems. SLPs work with people on feeding and swallowing skills. Babies with a cleft lip probably wont have trouble feeding, but babies with a cleft palate might. Babies with a cleft palate may have trouble breastfeeding, and they may need special bottles or nipples if they bottle-feed. SLPs can help you find the best bottle-and-nipple combination. […] SLPs also work with people on speech problems. Cleft lip may not create any speech problems, but a person with cleft palate may need help learning to speak more clearly. […] Audiologists manage hearing and balance problems. The audiologist will work with the physician to make sure that hearing loss is identified and addressed, if needed. Audiologists may help you to use amplification (like hearing aids) or other hearing technology.

• #2 Cleft Lip/Cleft Palate | Birth Defects | CDC

  https://www.cdc.gov/birth-defects/about/cleft-lip-cleft-palate.html

  Surgery to repair a cleft lip usually occurs in the first few months of life. It is recommended within the first 12 months of life. […] Surgery to repair a cleft palate is recommended within the first 18 months of life, or earlier if possible. Many children will need additional surgical procedures as they get older. […] Surgical repair can help restore function to the lips and mouth. It may help improve breathing, hearing, and speech and language development. Children born with orofacial clefts may also need special dental or orthodontic care or speech therapy. […] With treatment, most children with orofacial clefts do well and lead a healthy life. Some children may have issues with self-esteem if they are concerned with visible differences between themselves and other children.

• #2 The Management of Cleft Lip and Palate: Pathways for Treatment and Longitudinal Assessment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2884751/

  The care of children with cleft deformities is best managed by a dedicated team of specialists committed to their care from the time of diagnosis until adulthood. This craniofacial team works together to orchestrate the complicated treatment plan. […] The management of cleft lip and palate represents a commitment to the care of the afflicted child over the course of the child’s development into adulthood. The role of a qualified surgeon in this population of patients is obvious; however, the special needs of children with clefts are best served by the participation of a craniofacial team. […] A road map of surgical and nonsurgical care that is needed for each patient from the initial visit is created. […] The importance of the multispecialty approach to the care of children with clefts cannot be overemphasized.

• #2 Cleft Lip & Palate Association

  https://www.clapa.com/treatment/timeline/

  Every cleft is unique, just like every child, and everyone going through the care pathway will have different needs which will be handled by the individual cleft teams. […] The lip repair usually takes place when a child is at least 3 months old. […] The palate repair usually takes place between 6-12 months. […] Speech and Language Therapy Assessment – This usually takes place at around 18 months. Treatment will be offered if necessary, but the need may not become apparent until the child is older. […] An Alveolar Bone Graft (ABG) procedure is performed when there is insufficient bone in the area of the gum-line defect. […] Surgery may be required or requested for a number of different reasons, e.g. rhinoplasty (surgery to change the shape of the nose), dental surgery, lip revision, speech revision, palatal fistulae closure (closing small holes in the palate), etc. […] Adults may re-enter the cleft service at any time for a consultation about any aspect of their care, including psychological support, genetic counselling and specialist dental treatment, which is all available on the NHS if it is deemed necessary.

• #2 Cleft lip and cleft palate – Wikipedia

  https://en.wikipedia.org/wiki/Cleft_lip_and_cleft_palate

  Cleft lip and palate is very treatable; however, the kind of treatment depends on the type and severity of the cleft. […] Most children with a form of clefting are monitored by a cleft palate team or craniofacial team through young adulthood. Care can be lifelong and are looked after by craniofacial cleft teams often consist of: cleft surgeons, orthodontists, speech and language therapists, restorative dentists, psychologists, ENT surgeons and audio-logical physicians. Treatment procedures can vary between craniofacial teams. For example, some teams wait on jaw correction until the child is aged 10 to 12, while other teams correct the jaw earlier. […] Within the first 23 months after birth, surgery is performed to close the cleft lip. While surgery to repair a cleft lip can be performed soon after birth, often the preferred age is at approximately 10 weeks of age, following the „rule of 10s.” If the cleft is bilateral and extensive, two surgeries may be required to close the cleft, one side first, and the second side a few weeks later. The most common procedure to repair a cleft lip is the Millard procedure.

• #2 Cleft Lip and Palate: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/oral-health/cleft-lip-cleft-palate

  Other surgeries improve the look of the lip and nose, close openings between the mouth and nose, help with breathing, and straighten the jaws and teeth. Some children will not have their last surgery until the teen years once their face has grown. […] Your child’s doctor may suggest one or more of these treatments to fix complications from a cleft lip and palate: braces to straighten the teeth, ear tubes and other treatments for ear infections, feeding therapy, hearing aids, speech therapy, talk therapy to manage the stress of living with cleft lip and palate. […] Treatment for a cleft lip and cleft palate can take many years and involve several surgeries. But most children with this condition can have a normal childhood and life.

• #2 Cleft Lip and Palate: Signs and Treatment | Brown University Health

  https://www.brownhealth.org/be-well/cleft-lip-and-palate-signs-and-treatment

  Babies born with these conditions can live normal and healthy lives. Treatment of these conditions is best when started at a young age. However, it is never too late to seek care. Even older adults can have their clefts repaired. […] Cleft lip and cleft palate are treated with surgeries that happen at a very early age. These babies are evaluated by a team of pediatric experts, including dentists, speech therapists, plastic surgeons, and ear, nose, and throat doctors. Cleft lip repair typically happens before the baby is six months old, and cleft palate repair is done between 12 and 18 months. They may also need additional surgeries when they get older to optimize their appearance and function. This includes fixing a gap in the gums, helping with speech problems, or improving the appearance and function of the nose. As children born with cleft lip or cleft palate age, they are assessed by speech therapists, ENT doctors, and other experts to determine what additional help may be needed. It is also good to know that someone is never too old to have surgery for a cleft disorder. Our specialists even take care of adults who have lived with this problem for many years and are finally ready to have it fixed.

• #3 Cleft Lip & Palate Treatment Options | New York Eye & Ear

  https://www.nyee.edu/care/ent/facial-plastic-surgery/cleft-lip-palate/treatment

  Cleft Lip and Palate Treatment Options […] The repair of the cleft lip and cleft palate at an appropriate age is important for the child to be able to develop understandable speech, and to prevent difficulty with eating and swallowing. […] Surgical interventions to repair cleft lip and palate deformities may include speech surgery for velopharyngeal insufficiency, alveolar bone grafting and gingivoperiosteoplasty, cleft rhinoplasty, orthodontics, and complex dental care. […] In addition to surgical interventions, comprehensive and ongoing speech therapy is a part of our routine treatment plan with cleft palate patients. […] Before proposing a customized treatment plan for cleft lip and palate, the specialists at NYEE consider the functional and aesthetic factors of each case. […] Treatments for cleft lip and palate are generally recommended at the following ages: Birth: Experts may diagnose clefting and associated anomalies and create a tentative plan of care, including immediate feeding interventions. […] 10 Weeks: Experts may perform cleft lip repair and cleft nose repair, and insert ear tubes. […] 9 Months to One Year: Experts may perform cleft palate repair. […] 3-5 Years: Experts may provide speech therapy and adjunctive surgical procedures. […] 10-14 Years: Experts may perform bone grafting for Alveolar clefting. […] 14-17 Years: Experts may perform cleft rhinoplasty for definitive nasal repair when necessary.

Zobacz więcej