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Published on: June 20, 2018
[Children born with a cleft: treatment at the CHUV in Lausanne]
J Hohlfeld1, A de Buys Roessingh, G Herzog
1Service de chirurgie pédiatrique, CHUV, 1011 Lausanne. judith.hohlfeld@chuv.ch
Insights
Cleft lip and palate require lifelong, multidisciplinary care from diagnosis to adulthood. Specialized teams manage feeding, speech, dental, and psychological needs for optimal outcomes.
Area of Science:
- Craniofacial anomalies
- Pediatric care
- Genetics
Context:
- Cleft lip and palate (CLP) are common congenital conditions affecting facial development.
- Treatment necessitates a comprehensive approach due to the diverse and evolving needs of affected children.
- Early diagnosis and intervention are crucial for managing associated complications.
Purpose:
- To outline the essential components of a multidisciplinary team for cleft care.
- To emphasize the chronological and developmental aspects of cleft treatment.
- To highlight the collaborative efforts required among various medical specialties.
Summary:
- Clefts present in various forms, including labial, maxillary, and palatal, unilaterally or bilaterally.
- A multidisciplinary team addresses feeding, speech, ENT, dental, orthodontic, esthetic, and psychological issues.
- Care spans from prenatal diagnosis through childhood and adolescence, involving specialists like obstetricians and geneticists.
Impact:
- Optimizes treatment plans by integrating diverse expertise.
- Reduces the burden on families by providing coordinated care.
- Improves long-term functional and esthetic outcomes for children with clefts.
Abstract:
A cleft can be labial, labial-maxillary, unilateral or bilateral labial-maxillary-palatal, or isolated palatal. A multidisciplinary team includes several specialists who will handle the diverse problems of children born with a cleft. This team will follow the child through each developmental stage and assemble an optimal treatment plan, thus reducing the onus on the family. Depending on the type of cleft and the age of the child, feeding, speech, ORL, dental, orthodontic, esthetic and possibly also psychological problems will be taken care of. This is why cleft treatment starts at the time it is diagnosed, before or after birth, and ends when the child is fully grown. It requires a complete interdisciplinary team and the collaboration with obstetricians and geneticians.

