Cleft Palate Repair Guidelines

Updated: Jun 05, 2020
  • Author: Pravin K Patel, MD; Chief Editor: Jorge I de la Torre, MD, FACS  more...
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Guidelines

Guidelines Summary

Treatment for patients who are born with facial clefts is ideally accomplished through an interdisciplinary staff of professionals at a dedicated cleft/craniofacial center. The American Cleft Palate-Craniofacial Association has provided guidelines for such teams to help ensure the coordination and consistent administration of care, with evaluations and treatments properly sequenced in view of a patient’s developmental, medical, and psychological needs. Those guidelines are as follows [21] :

  • A designated patient coordinator on the team should facilitate its function and efficiency, as well as the coordination of care and treatment-plan assistance for patients and families/caregivers
  • The minimum core of the team must include speech-language pathology, surgery, and orthodontics professionals
  • The team must have access to psychology, social work, audiology, genetics, general and pediatric dentistry, otolaryngology, and pediatrics/primary care professionals
  • A surgeon trained in transcranial cranio-maxillofacial surgery must be part of the team, which must also have access to a psychologist involved in neurodevelopmental and cognitive assessment; access for referral to a neurosurgeon, an ophthalmologist, a radiologist, and a geneticist is also necessary
  • The team must provide the patient and family/caregiver with oral and written information about evaluation and treatment procedures
  • The patient and family/caregiver should be encouraged by the team to participate in the treatment process
  • Families/caregivers should receive team assistance in locating resources for financial help necessary to meet patient needs
  • Team care must be sensitive and flexible with regard to linguistic, cultural, and ethnic diversity among patients and their families/caregivers
  • The team must include or have available for referral social workers and psychologists who can see to the psychological and social needs of the patient and family/caregiver
  • The team must have a cognitive development evaluation mechanism
  • When necessary, cognitive psychometric testing must be administered to patients aged 4 or older whose craniofacial condition requires transcranial surgery
  • The team should self-assess its performance and make improvements accordingly