Evaluation of Multidisciplinary Team Clinic for Patients With Isolated Cleft Lip

William M. Padovano, Alison K. Snyder-Warwick, Gary B. Skolnick, Kristin D. Pfeifauf, Maithilee D. Menezes, Lynn M. Grames, Susan Cheung, Andrew M. Kim, Mary Michaeleen Cradock, Sybill D. Naidoo, Kamlesh B. Patel

Research output: Contribution to journalArticle

Abstract

Objective: To report the incidences of secondary lip and nose operations, otolaryngology procedures, speech-language therapy, neurodevelopmental concerns, and dental and orthodontic issues in children with isolated cleft lip to inform multidisciplinary cleft team protocols. Setting: An American Cleft Palate-Craniofacial Association–approved team at a tertiary academic children’s hospital. Design: Retrospective cohort study of patients evaluated through longitudinal clinic visits by a multidisciplinary cleft palate and craniofacial team between January 2000 and June 2018. Patients, Participants: Children with nonsyndromic cleft lip with or without cleft alveolus (n = 92). Results: Median age at final team visit was 4.9 years (interquartile range: 2.4-8.2 years). Secondary plastic surgery procedures were most common between ages 3 and 5 (135 per 1000 person-years), and the majority of these procedures were minor lip revisions. The rate of tympanostomy tube insertion was highest before age 3 (122 per 1000 person-years). By their final team visit, 88% of patients had normal hearing and 11% had only slight to mild conductive hearing loss. No patients had speech errors attributable to lip abnormalities. Psychological interventions, learning disabilities, and dental or orthodontic concerns were uncommon. Conclusions: Most patients with isolated cleft lip may not require long-term, longitudinal evaluation by cleft team specialists. Cleft teams should develop limited follow-up protocols for these children to improve resource allocation and promote value-based care in this patient population.

Original languageEnglish
Pages (from-to)900-908
Number of pages9
JournalCleft Palate-Craniofacial Journal
Volume57
Issue number7
DOIs
StatePublished - Jul 1 2020

Keywords

  • cleft lip
  • hearing loss
  • incidence
  • outcomes
  • speech therapy
  • value-based care

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    Padovano, W. M., Snyder-Warwick, A. K., Skolnick, G. B., Pfeifauf, K. D., Menezes, M. D., Grames, L. M., Cheung, S., Kim, A. M., Cradock, M. M., Naidoo, S. D., & Patel, K. B. (2020). Evaluation of Multidisciplinary Team Clinic for Patients With Isolated Cleft Lip. Cleft Palate-Craniofacial Journal, 57(7), 900-908. https://doi.org/10.1177/1055665619900625