 The
Cleft Palate/Craniofacial Clinic
Cleft lip, cleft palate and craniofacial surgery involves the comprehensive treatment of
children with congenital defects (birth defects) affecting their mouth, face and sometimes
skull. A cleft means a "split" or "separation" which can occur
anywhere in the body, but in these children occurs at the lip, nose or along the roof of
the mouth. Craniofacial birth defects can be varied but usually involve some aspect of an
abnormally shaped skull. Clefts of the lip and palate are the most common congenital
deformity of the face, affecting approximately one in every six hundred births. We do not
know exactly why clefts occur but they do run in families to some extent. They are more
common in Asian children and less common in African-American children.
As the child grows, many different parts of the face may be influenced by a cleft or
abnormally shaped skull. Therefore, care of a cleft or craniofacial child involves a
coordinated group of professionals who follow these children from birth until the
completion of growth. That team consists of: plastic surgeons, pediatricians, geneticists,
dentists, orthodontists, otolaryngologists, oral surgeons, speech therapists,
audiologists, social workers and sometimes neurosurgeons/ophthalmologists. At ECU/PCMH,
the Cleft Palate/Craniofacial Clinic organizes this care, coordinating and tracking the
treatment and progress of these children through the years.
What to expect
Although each child is different, the following are some guidelines generally used with
cleft lip, cleft palate and craniofacial defect children.
The Cleft Lip and Palate Child
| Within the first three
weeks of life the child has his/her first evaluation in the clinic for: |
proper feeding
hearing
genetic counseling |
dental/palatal impressions
general counseling and support
social services to help with family or financial considerations |
|
| Between 0-3 months: |
dental splints for cleft
palate children, if indicated
routine pediatric visits |
| At approximately 3
months of age: |
| surgical cleft lip repair |
| Between 3 and 12 months
of age: |
· dental splints for
cleft palate children, if indicated
· one or two hearing/ear evaluations
· one speech evaluation
|
| At approximately 12 months
of age: |
surgical cleft palate
repair
placement of ear tubes, if necessary
|
| Between 12 months and 5
years: |
periodic (e.g.
annual/bi-annual) clinic assessment of:
à speech (if abnormal, speech therapy started through school, etc.)
à hearing
à dental
à social/emotional development
possible palate repair revision if speech suboptimal |
| Between 5 and 7 years: |
in cleft palate patients, prepare primary teeth orthodontically for surgical bone
graft of cleft before permanent teeth erupt
continue speech assessment
consider first surgical revision/refinement of lip and/or nose |
| Between 7 and 9 years: |
| surgical bone grafting of
bony palatal defect using bone from the hip |
| Between 9 and teenage
years: |
orthodontic treatment
plan final rhinoplasty in late adolescence
jaw surgery if growth of upper or lower jaw impaired by cleft |
The Craniofacial Anomaly Child
There are many different types of craniofacial anomalies, therefore, this general outline
may vary quite a bit depending on the specific diagnosis.
| Within the first three
weeks of life the child has his/her first evaluation in the clinic for: |
feeding
hearing
sight
general counseling and support |
genetics
social work
CAT scan to define abnormality
dental impressions, if indicated |
|
| Between 0-3 months: |
dental splints, if
indicated
routine pediatric visits |
| At approximately 3-6
months of age: |
| surgical skull remodeling
(plastic surgery and neurosurgery) |
| Between 6 months and 3
years of age: |
speech evaluations
dental evaluations
eye evaluations |
ear evaluations and
placement of ear tubes if necessary
assessment of intelligence
consider re-operation on skull at either one year or three years if X-rays show growth is
not good enough |
|
| Between 3 years and 7
years: |
dental/orthodontic
treatment
speech therapy
assessment of intelligence and social function |
| Between 7 years and
adolescence: |
orthodontic treatment
plan final rhinoplasty in late adolescence
jaw surgery if growth of upper or lower jaw impaired by deformity |
upper face bone surgery if
eye sockets or nose did not grow into the right place
ophthalmic surgery if eye muscles are not working correctly |
|
For any additional questions, please feel free to call either the Cleft
Palate/Craniofacial Clinic or the Plastic Surgery Office
The Cleft Palate/Craniofacial Clinic 252.847.0419
Division of Plastic and Reconstructive Surgery 252.744.5291
Related Sites
American Cleft Palate Association
Cleft Palate Foundation
March of Dimes
Areas of Interest
Head and Neck Cancer
Cleft Lip/Craniofacial Surgery
General Reconstruction
Breast Cancer Reconstruction
Research
Aesthetic/Cosmetic Surgery
Directions to Office
The University Health
Systems of Eastern Carolina
Cleft/Craniofacial Clinic
is part of the Outpatient Rehabilitation Center at
Pitt County Memorial Hospital
2310 Stantonsburg Road
Greenville, NC 27834
(252) 847-0419
Mailing Address
Cleft Database Office
East Carolina University Physicians
600 Medical Drive
Greenville, NC 27835
|
