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The Pharynx and Oral Cavity
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
Cleft of the lip and/or palate occurs in about 1 in 700 births. Most cases are of unknown aetiology, but factors that increase the risk include maternal use of some anticonvulsant agents (phenobarbital, phenytoin), maternal use of alcohol and tobacco, and steroids. Dedicated multidisciplinary teams including a cleft surgeon, orthodontist, speech and language therapist, and otolaryngologist are now well established and offer optimum care for these children and their families. ORL issues include otitis media, nasal deformity with functional and aesthetic issues, and airway obstruction.
Embryological Development Disorders
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Cleft palate: Defect of secondary palateMay be incomplete, complete, bilateral, unilateral, or submucous
Clefts and craniofacial
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Cleft lip is a congenital abnormality of the primary palate and may be complete/incomplete/microform or unilateral/bilateral, and may coexist with a CP. CL alone or in combination with a CP is the same entity but represents different points along the morphological spectrum.
Publication trends in cochlear implantation outcome measures
Published in Hearing, Balance and Communication, 2023
Priya Sethukumar, Nikul Amin, Andrew Hall, Robert Nash
The use of clearly defined outcomes in monitoring the effect of interventions is already well established in the context of the cleft service, with prospective data collection in the Cleft Registry and Audit NEtwork [72]. Patients with cleft lip/palate require ongoing multidiscipline care from birth to adulthood, which is not dissimilar to the long-term complex needs of CI recipients. The constant review of multidisciplinary clinical outcomes at set time-points is very much embedded in the clinical pathway [73]. This model has been highly effective in the management of cleft patients, and the benefits of a similar paradigm could be considered for CI patients. Furthermore, the prospective capture of information can be used to inform care, and as with the CRANE database for the cleft service, CI patients could also benefit. Agreement on key COS is pivotal to the development of such registries.
Additional diagnoses in children with cleft lip and palate up to five years of age
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Ellen Aspelin, Måns Cornefjord, Kristina Klintö, Magnus Becker
Cleft lip and palate (CL/P) is the most common congenital craniofacial malformation [1]. Out of 1400 live births in Sweden, approximately two children are born with this malformation every year [2]. CL/P shows significant variation in its clinical presentation and its embryological background is complex. The cause of the condition is not fully understood, and there are several potential explanations for its occurrence. It development seems to be subject to a combination of genetics [3], environment [4], and lifestyle of the parents [4]. Depending on the nature of the cleft, it can affect structures such as the lip, palate and alveolus to different extents and in different combinations. It in turn, this affects appearance and functions such as hearing [5,6] and speech [7]. The main treatment for CL/P in Sweden is surgical intervention in combination with follow-up and treatment by one of six regional multidisciplinary CL/P treatment teams [8].
Speech diagnosis and intervention in children with a repaired cleft palate: A qualitative study of Flemish private community speech–language pathologists’ practices
Published in International Journal of Speech-Language Pathology, 2022
Cassandra Alighieri, Kim Bettens, Sofie Verhaeghe, Kristiane Van Lierde
The complex care of children with a cleft of the palate with or without a cleft of the lip (CP ± L) is usually coordinated by an interdisciplinary team (Crockett & Goudy, 2014). Globally, the cleft team comprises a cleft surgeon, an oral-maxillofacial surgeon, an orthodontist and paediatric dentist, a paediatric geneticist, a (social) nurse, an audiologist, a speech–language pathologist (SLP) and a psychologist (Crockett & Goudy, 2014). The different health practitioners collaborate to provide the most effective treatment and medical and emotional support to the children and their families (Crockett & Goudy, 2014). One of the primary and most important outcomes in children with a repaired CP ± L is speech (Bessell et al., 2013). Therefore, SLPs are an integral and important part of the interdisciplinary cleft team. The SLP is responsible for diagnosing and treating active or compensatory speech errors. Active or compensatory speech errors are considered an attempt to compensate for the structural cleft-related deficiency (Harding & Grunwell, 1998; Kummer, 2011). Examples of such speech errors are the production of glottal stops or active nasal fricatives (Harding & Grunwell, 1998; Kummer, 2011). Because there is an alternation in the place or manner of articulation, speech intervention is indicated (Harding & Grunwell, 1998; Kummer, 2011). In addition to managing speech, SLPs also can be involved in counselling the family about any feeding issues that might be present or educating other professionals about the needs of individuals with a CP ± L.