Updates in Cleft Care

Abstract

Cleft lip and/or palate is a congenital malformation with a wide range of presentations, and its effective treatment necessitates sustained, comprehensive care across an affected child's life. Early diagnosis, ideally through prenatal imaging or immediately postbirth, is paramount. Access to longitudinal care and long-term follow-up with a multidisciplinary approach, led by the recommendations of the American Cleft Palate Association, is the best way to ensure optimal outcomes. Multiple specialties including plastic surgery, otolaryngology, speech therapy, orthodontists, psychologists, and audiologists all may be indicated in the care of the child. Primary repair of the lip, nose, and palate are generally conducted during infancy. Postoperative care demands meticulous oversight to detect potential complications. If necessary, revisional surgeries should be performed before the child begin primary school. As the child matures, secondary procedures like alveolar bone grafting and orthognathic surgery may be requisite. The landscape of cleft care has undergone significant transformation since early surgical correction, with treatment plans now tailored to the specific type and severity of the cleft. The purpose of this text is to outline the current standards of care in children born with cleft lip and/or palate and to highlight ongoing advancements in the field.

Evaluation of facial pleasantness in patients with complete and unilateral cleft lip and palate rehabilitated and submitted to orofacial harmonization

“…The rehabilitation protocol for these patients includes lip, nose and palate repair, alveolar bone grafting, and orthodontics, isolated or combined with orthognathic surgery. 4,5,6 The morphological sequelae of these primary surgeries (cheiloplasty and palatoplasty) influence craniofacial growth mainly by three-dimensional restriction of maxillary development. This maxillary underdevelopment contributes to the occurrence of Class III occlusal relationships, anterior crossbite and midface retrusion, and is related to speech-disorders and respiratory and facial disharmonies.…”