Craniofacial Surgery Research Articles

Drilling and Groove-cutting Technique for Safe and Complete Removal of Forehead Osteomas on the Anterior Table of the Frontal Sinus.

Forehead osteomas are benign tumors commonly excised for cosmetic and functional reasons. However, removing osteomas from the anterior table of the frontal sinus presents specific challenges, particularly in determining the appropriate removal thickness. Inaccurate resection depth may result in fracture or perforation of the anterior table of the frontal sinus, or incomplete resection. The authors propose a novel drilling and groove-cutting technique to ensure safe and complete excision while minimizing risks of fracture or perforation of the anterior table. In this study, the authors present a 51-year-old female patient with a recurrent osteoma. Preoperative computed tomography (CT) imaging-guided depth-limiting drilling at the osteoma's center, followed by groove-cutting to establish excision boundaries. Then divided osteoma blocks were excised completely. Postoperatively, the patient showed no sensory deficits or forehead asymmetry and achieved pleasing frontal contour with minimal scarring. This technique effectively safeguards the anterior table and ensures complete removal, demonstrating its utility in craniofacial surgery.

Skeletal abnormalities caused by a Connexin43R239Q mutation in a mouse model for autosomal recessive craniometaphyseal dysplasia

Craniometaphyseal dysplasia (CMD), a rare craniotubular disorder, occurs in an autosomal dominant (AD) or autosomal recessive (AR) form. CMD is characterized by hyperostosis of craniofacial bones and metaphyseal flaring of long bones. Many patients with CMD suffer from neurological symptoms. The pathogenesis of CMD is not fully understood. Treatment is limited to craniofacial surgery. Here, we report a knock in (KI) mouse model for AR CMD carrying a Cx43R239Q mutation. Cx43KI/KI mice replicate typical features of AR CMD, including thickening of craniofacial bones, club-shaped femurs, and widened diaphyseal cortical bones. Female Cx43KI/KI mice display remarkably more bone overgrowth than male Cx43KI/KI mice as they age. In contrast to Cx43+/+ littermates, Cx43KI/KI mice exhibit periosteal bone deposition and increased osteoclast (OC) numbers in the endosteum of long bones. Although formation of resting OCs in Cx43+/+ and Cx43KI/KI mice is comparable, the actively resorbing Cx43KI/KI OCs have reduced resorption on bone chips. Cx43KI/KI mice display reduced osteocyte dendrites. RNA from Cx43KI/KI femoral cortical bones show reduced expression levels of Sost, Tnf-α, IL-1β, Esr1, Esr2, and a lower Rankl/Opg ratio. Moreover, the Cx43R239Q mutation results in altered spatial expression of Cx43 protein and mild reduction of gap junction and hemichannel activity. The distinct phenotype seen in Cx43KI/KI mice but not in Cx43 ablation models suggests that Cx43 loss-of-function is unlikely the main cause of AR CMD. Additional studies are required to investigate new roles of CMD-mutant Cx43.

A morphometric analysis of the cranial base in trigonocephaly.

Trigonocephaly occurs when the metopic suture fuses prematurely. Few studies have documented the morphometry of the entire anterior cranium in trigonocephaly and not on the morphometric changes to the cranial fossae alone. Thus, this study aimed to determine and compare the dimensions of the anterior cranial fossa (ACF) in trigonocephaly and control groups. Additionally, volumetric assessments of the middle and posterior cranial fossae (MCF and PCF) were analysed to determine the amount of compensatory growth in these regions. Anatomical landmarks were used to measure the morphometry of the ACF, and volumes of the MCF and PCF on preoperative two-dimensional computed tomography scans of fifteen non-syndromic, isolated trigonocephaly patients between 2012 and 2023, and eight controls. Comparative assessment of the ACF revealed larger dimensions in younger more severe trigonocephaly patients when compared to the control cohort. Smaller ACF dimensions were recorded in older patients who presented with moderate and severe trigonocephaly compared to the control cohort. The volume of the MCF was found to be significant (p=0.05), and the volume of the PCF was larger in trigonocephaly patients compared to controls. The PCF showed the largest incidence of compensatory growth (30.4%) in trigonocephaly patients. The frontal angle (FA) (p=0.004) and endocranial bifrontal angle (EBA) were used to categorise the severity of trigonocephaly. The morphometric data obtained could assist craniofacial surgeons in understanding the changes that occur in the ACF to decide which type of corrective treatment is most suitable.

Cleft-Related Revision Procedures: Surgeon Perspectives on Shared Decision-Making and a Decision Aid Prototype.

Decision-making for elective cleft lip and nose revisions varies widely, from patient-led decisions to more paternalistic approaches. As these procedures incur additional scarring that may impact future interventions, patients should be equipped to participate in these surgical decisions. We thus developed a decision aid based on international standards, and to ensure methodologic rigor, we sought feedback from other surgeons regarding shared decision-making and potential barriers to adopting the decision aid. The decision aid was developed based on qualitative patient data, expert opinion, and International Patient Decision Aid Standards (IPDAS). It was first piloted using a "think aloud" approach and subsequently revised. In the present study, this version was presented to a diverse focus group of surgeons. The conversation was audio-recorded and transcribed. The transcription was coded independently by 2 authors, and codes were categorized for theme development. American Cleft Palate-Craniofacial Association meeting, April 2024. Focus group of 8 board-certified craniofacial surgeons. Surgeon feedback regarding appeal, usefulness, and generalizability of the decision aid. Eight surgeons participated. Mean age was 43 years (SD 5.7), and mean number of years in practice was 9.3 (SD 6.0). Four were female, and 4 were male. Three themes emerged: (1) Appeal to the consumer, (2) Acknowledge the parents, and (3) Consider logistics of decision aid delivery. Based on surgeon feedback, the decision aid will be web-based, explicitly recognize the importance of parents, and maximize the likelihood that patients viewing the decision aid are surgical candidates.

Evaluation of PCORnet as an Approach to Accessing Electronic Health Record (EHR) Data for Cleft Outcomes Research: Advantages and Limitations.

Objective: To evaluate the feasibility of using the National Patient-Centered Clinical Research Network (PCORnet®) as a source of electronic health record (EHR) data for cleft outcomes research. Design: Exploratory retrospective analysis of multi-year, administrative and clinical, structured data stored in PCORnet. Setting: Academic institution with an ACPA-approved cleft and craniofacial team. Patients/Participants: Encounter-level data pertaining to patients with orofacial clefts treated at this center between 2010 and 2018. Outcome Measures: (1) Ability of PCORnet to report metrics such as the following: number of new and returning patients per year; demographics; phenotype; procedures; readmission or reoperation within 30 days; etc. (2) Accuracy of selected metrics, compared with manual chart review. Results: PCORnet is useful for the calculation of simple process metrics such as patient demographics, phenotype mix, case mix, and number of readmissions. However, as it lacks access to clinical notes, PCORnet alone cannot provide more detailed information. Phenotypic classification (based on ICD codes) and procedural description (based on CPT®) are subject to inaccuracy. A 1-2 year delay in data upload to PCORnet may be rate-limiting for certain applications. Multi-institutional queries were feasible. Conclusions: PCORnet does not include all necessary data elements from the EHR. While very convenient for the tabulation of simple process metrics, especially from multiple institutions, supplemental data collection will be required for meaningful cleft outcomes research. Cleft teams whose institutions participate in PCORnet might choose to store the supplemental data as "sidecars" alongside the standard PCORnet database tables, which would allow for future PCORnet queries to be more informative and impactful.

Evaluation of osseointegration of plasma treated polyaryletherketone maxillofacial implants

Osseointegration is a crucial property of biomaterials used for bone defect repair. While titanium is the gold standard in craniofacial surgeries, various polymeric biomaterials are being explored as alternatives. However, polymeric materials can be bioinert, hindering integration with surrounding tissues. In this investigation, plasma ion immersion implantation (PIII)-treated polyether ether ketone (PEEK) and polyether ketone (PEK) implants were assessed in a sheep maxilla and mandible model. Defects were filled with PIII-treated PEEK and PEK implants, produced through fused filament fabrication (FFF) and selective laser sintering (SLS), respectively. Positive controls were grade 23 titanium implants via selective laser melting, while untreated PEEK implants served as negative controls. Surface analyses using scanning electron microscopy and atomic force microscopy revealed favorable properties. Osseointegration was qualitatively and quantitatively assessed at 8-, 10-, and 12-weeks post-implantation, showing significantly improved outcomes for both PIII-treated PEEK and PEK implants compared to untreated controls. The study suggests PIII treatment enhances FFF-printed PEEK’s osseointegration, and PIII-treated SLS-printed PEK achieves comparable osseointegration to 3D printed titanium. These findings underscore surface modification strategies’ potential for polymeric biomaterials, offering insights into developing alternative implant materials for craniofacial surgeries, with enhanced biocompatibility and osseointegration capabilities for improved clinical outcomes.

Design, Development, and Evaluation of a 3D-Printed Buccal Myomucosal Flap Simulator.

Buccal myomucosal flap procedures have become a critical tool in the armamentarium of the cleft surgeon. Mastering this technique is complex and providing sufficient training opportunities presents significant challenges. Our study details the design, development, and evaluation of a low-cost, high-fidelity buccal myomucosal flap surgical simulator. Our goal is to establish a reliable teaching tool for early learners, validated through craniofacial surgeon assessment. The simulator comprises of an anatomical model and a stand created using computer-aided design software. Hard tissues were 3D-printed, while soft tissues were cast in silicone. The model underwent review by craniofacial surgeons utilizing a 1 to 5 Likert scale across six evaluation domains. In-person simulated dissection session. Sixteen craniofacial surgery providers from various subspecialties. None. Anonymized survey responses. The simulator received fair to high scores across all evaluation domains, notably 4.31 as a training tool, 3.77 as a competency evaluation tool, 3.92 as a rehearsal tool, and 3.93 in relevance to practice. The validated buccal myomucosal flap simulator theoretically enables the acquisition of surgical skills in a zero-risk simulated environment. Plans involve integration into a structured curriculum with diverse participants. Continued iteration and adoption hold the promise of significantly enhancing access to training for competency of cleft and craniofacial procedures.

Sports after single-suture synostosis surgery: a survey of Synostosis Research Group members.

Patients with a history of surgery for single-suture craniosynostosis (SSC) as an infant often wish to participate in sports later in childhood. However, there are no established guidelines from neurosurgeons and craniofacial surgeons to guide parents in which sports their child should or should not participate. Therefore, this study aimed to evaluate the attitudes and practice patterns of experienced neurosurgeons and craniofacial surgeons regarding the counseling of caregivers of these patients about sports participation. A survey was administered to neurosurgeons and craniofacial plastic surgeons of the Synostosis Research Group (SynRG), a group of 9 North American institutions, to identify attitudes toward sports participation in patients with past SSC surgery. Survey responses were collected anonymously in REDCap. Questions regarding specific sports participation recommendations for patients who underwent surgery as an infant for SSC with ideal healing and for those who required a delayed cranioplasty were answered. Questions pertained to patients with nonsyndromic SSC without associated Chiari malformation, syrinx, or other intracranial/intraspinal anomalies. Overall, 20 surgeons were invited to participate in the survey, with 18 (90%) (9 neurosurgeons and 9 craniofacial plastic surgeons) fully completing it. Only 1 (5.6%) surgeon counseled against any sports participation for patients with ideal healing. If cranioplasty was required, 39%-50% of surgeons counseled against some participation (most commonly restricting football/rugby, boxing, ice hockey, lacrosse, and wrestling), depending on the extent of the cranioplasty. Overall, more plastic surgeons (56%-67%) counseled against sports participation (including lower-contact sports such as baseball/softball, basketball, gymnastics, and soccer) than neurosurgeons (22%-33%) in patients who required cranioplasty. SynRG surgeons generally did not counsel against sports participation (including contact sports) for children with a history of SSC surgery as an infant who had ideal healing. In patients requiring cranioplasty, 39%-50% of surgeons recommended against high-contact sports participation.

Discussion: Travel Burden to American Cleft Palate and Craniofacial Association-Approved Cleft and Craniofacial Teams: A Geospatial Analysis.

Discussion: Travel Burden to American Cleft Palate and Craniofacial Association-Approved Cleft and Craniofacial Teams: A Geospatial Analysis.

New Productive Force: The Preliminary Report of First Craniofacial Surgical Robot IST Multicenter Clinical Trial in China.

This paper presents the authors' team's research on a craniofacial surgical robot developed in China. Initiated in 2011 with government funding, the craniofacial surgical robot project was officially launched in Shanghai, developed jointly by the Ninth People's Hospital affiliated with Shanghai Jiao Tong University School of Medicine and the Shanghai Jiao Tong University medical-engineering team. Currently, based on multiple rounds of model surgeries, animal experiments, and clinical trials, our team is applying for approval as a Class III medical device from the National Medical Products Administration (NMPA). As an innovative tool in the field of craniofacial surgery, it fills a technological gap within the country. This study is a multicenter cohort study based on patient data from Shanghai Ninth People's Hospital from 2019 to 2024. Inclusion criteria included patients who underwent craniofacial surgery with complete follow-up data, with the primary variable being the use of robotic assistance in craniofacial surgery. Data analysis involved descriptive statistics, t tests, and multivariable regression, with a significance level set at P<0.05. The craniofacial surgical robot has been widely explored in the fields of congenital deformities, tumor reconstruction, and esthetic surgery. In the clinical trials discussed in this article, which included experiments on both craniofacial deformity correction surgeries and esthetic surgeries, a total of 39 patients were enrolled. In mandibular osteotomy surgery, robotic-assisted procedures can reduce osteotomy length error by an average of 2.2mm and mandibular angle error by 9.09 degrees, while also decreasing the average surgery time by 10.43 minutes. In hemifacial microsomia distraction osteogenesis surgery, robotic-assisted surgery can reduce osteotomy length error by an average of 4.6mm and shorten the average surgery time by 60 minutes. The robotic-assisted group also showed better perioperative outcomes for patients. The surgical precision was improved and there was a significant reduction in postoperative complications. The authors' research team has completed the first multicenter study on craniofacial surgical robots in China, demonstrating that this robot significantly enhances surgical precision, reduces operation time, and improves perioperative patient indicators. These findings indicate that the robot is highly effective in assisting surgeons with complex procedures. The study suggests that, in the future, this robot is likely to be widely adopted in craniofacial surgery, significantly advancing surgical efficiency and precision, and bringing transformative progress to clinical practice.

Progress in Science and Technology as Reflected in the Scholarly Publications of a Craniofacial and Pediatric Plastic Surgery Periodical.

Progress in Science and Technology as Reflected in the Scholarly Publications of a Craniofacial and Pediatric Plastic Surgery Periodical.

Digital Twins Use in Plastic Surgery: A Systematic Review.

Background/Objectives: Digital twin technology, initially developed for engineering and manufacturing, has entered healthcare. In plastic surgery, digital twins (DTs) have the potential to enhance surgical precision, personalise treatment plans, and improve patient outcomes. This systematic review aims to explore the current use of DTs in plastic surgery and evaluate their effectiveness, challenges, and future potential. Methods: A systematic review was conducted by searching PubMed, Scopus, Web of Science, and Embase databases from their infinity to October 2024. The search included terms related to digital twins and plastic surgery. Studies were included if they focused on applying DTs in reconstructive or cosmetic plastic surgery. Data extraction focused on study characteristics, technological aspects, outcomes, and limitations. Results: After 110 studies were selected for screening, 9 studies met the inclusion criteria, covering various areas of plastic surgery, such as breast reconstruction, craniofacial surgery, and microsurgery. DTs were primarily used in preoperative planning and intraoperative guidance, with reported improvements in surgical precision, complication rates, and patient satisfaction. However, challenges such as high costs, technical complexity, and the need for advanced imaging and computational tools were frequently noted. Limited research exists on using DTs in postoperative care and real-time monitoring. Conclusions: This systematic review highlights the potential of digital twins to revolutionise plastic surgery by providing personalised and precise surgical approaches. However, barriers such as cost, complexity, and ethical concerns must be addressed. Future research should focus on validating clinical outcomes through large-scale studies and developing soft tissue modelling and real-time monitoring capabilities.

Virtual Surgical Planning in Craniofacial Surgery: The Top 50 Most Frequently Cited Papers.

Background: Reporting the 50 most cited manuscripts on virtual surgical planning (VSP) for craniofacial surgery, thereby providing a comprehensive review of landmark papers. Methods: The Web of Science Citation Index was used to identify the 50 most cited manuscripts on VSP in craniofacial surgery. These were classified by level of evidence, type of study, topic of interest, and anatomic site. Results: The mean number of citations was 126.3 ± SD 51.7. Twenty were clinical papers: 9 reviews, and 21 workflow or technology. The most common level of evidence (LoE) was 4 (n = 12), followed by 3 (n = 6), 2 (n = 1), and 5 (n = 1). Thirty-nine of 50 articles focused on the maxillomandibular area of the face, 5 zygomatic, 5 orbit, 2 cranial vault, and 1 nasal ethmoid bone. The majority of articles (37 of 50) were on orthognathic surgery, 11 facial reconstruction, 2 calvarium reconstruction or craniosynostosis, and 2 free flap procedures. Year of publication ranged from 2000 to 2019; 34 articles were published in craniomaxillofacial journals. Conclusion: VSP is a relatively new technology and most highly cited articles on this topic pertain to workflow, technology, and protocols, as these are necessary for its integration into clinical practice. In our list, VSP was most used in orthognathic surgery; however, due to the potential increased efficiency and accuracy, it is being explored in other areas of craniofacial surgery such as facial reconstruction and craniosynostosis. Accordingly, we expect to see increasingly widespread usage of VSP in other areas of surgery, which could potentially lead to highly cited papers.

Craniosynostosis: Epidemiology and Pattern at a Tertiary Referral Institute in Oman 2004 to 2023.

To date, there are no published studies From the Sultanate of Oman on the incidence or characteristics of craniosynostosis (CS). This is a population-based epidemiological study of the incidence of CS. The prospective registry of the craniofacial surgery unit in Khoula Hospital was used to retrieve data on all individuals with CS treated between 2004 and 2023. The cohort was divided into four 5-year groups based on year of birth: 2004 to 2008, 2009 to 2013, 2014 to 2018, and 2019 to 2023. We identified 312 individuals with CS. The incidence increased significantly during the study period and was 2.5 per 10 000 live births in the last 5-year period. There was a male preponderance (male/female ratio 1.5:1). Our study findings reveal a notable diversity in the trend of suture involvement, we observed a higher frequency of complex CS within our study population 35.9%. Half of the study population was nonsyndromic, accounting for 51.6%. The nonsyndromic population exhibits a higher proportion of midline suture involvement. The incidence of CS increased during the study period. The majority of cases were identified as nonsyndromic. We found that multiple sutures CS were the most prevalent overall in our population. It is imperative to intensify efforts aimed at raising awareness among the general population regarding these deformities.

Clinical deployment of machine learning models in craniofacial surgery: considerations for adoption and implementation

Clinical deployment of machine learning models in craniofacial surgery: considerations for adoption and implementation

Application of dynamic navigation technology in oral and maxillofacial surgery.

Dynamic navigation (DN) technology has ushered in a paradigm shift in dentistry, revolutionizing the precision of diverse procedures in oral and craniofacial surgery. This comprehensive review aims to review the manifold applications of DN, including implantology, endodontics, oral and dental surgeries, and other dental disciplines. A thorough search of the online databases PubMed and Google Scholar was conducted up to March 2024. Publications associated with DN in the field of oral and maxillofacial surgery were sourced. Narrative literature review. DN harnesses cone beam computerized tomography imaging, virtual design software, and motion tracking technology to construct a virtual model of the patient's oral cavity, affording real-time instrument tracking during procedures. Notably, in implantology, DN facilitates implant placement, enhances safety measures, and augments procedural efficiency. The application of DN in sinus lift procedures contributes to improved surgical outcomes and reduced complications. Within endodontics, DN guides root canal treatment (RCT), retreatment of failed RCT, and endodontic microsurgery, ensuring conservative access cavities and precise canal location. Beyond these, the versatility of DN extends to encompass maxillomandibular and orthognathic surgeries, tooth extraction, removal of foreign bodies, and facial reconstruction. However, it is crucial to acknowledge potential disadvantages and error-prone scenarios as DN technologies advance. DN technology empowers dentists with high accuracy, heightened safety protocols, and increased procedural efficiency, culminating in enhanced patient outcomes across various dental procedures. As DN technology further expands, its pivotal role will advance in the future of oral and maxillofacial surgery.

Fronto-orbital advancement with patient-specific 3D-printed implants and robot-guided laser osteotomy: an in vitro accuracy assessment.

The use of computer-assisted virtual surgical planning(VSP) for craniosynostosis surgery is gaining increasing implementation in the clinics. However, accurately transferring the preoperative planning data to the operating room remains challenging. We introduced and investigated a fully digital workflow to perform fronto-orbital advancement(FOA) surgery using 3D-printed patient-specific implants(PSIs) and cold-ablation robot-guided laser osteotomy. This novel approach eliminates the need for traditional surgical templates while enhancing precision and customization, offering a more streamlined and efficient surgical process. Computed tomography data of a patient with craniosynostosis were used to digitally reconstruct the skull and to perform VSP of the FOA. In total, six PSIs per skull were 3D-printed with a medical-grade bioresorbable composite using the Arburg Plastic Freeforming technology. The planned osteotomy paths and the screw holes, including their positions and axis angles, were digitally transferred to the cold-ablation robot-guided osteotome interface. The osteotomies were performed on 3D-printed patient skull models. The implants, osteotomy and final FOA results were scanned and compared to the VSP data. The osteotomy deviations for the skulls indicated an overall maximum distance of 1.7mm, a median deviation of 0.44mm, and a maximum root mean square(RMS) error of 0.67mm. The deviation of the point-to-point surface comparison of the FOA with the VSP data resulted in a median accuracy of 1.27mm. Accessing the orbital cavity with the laser remained challenging. This in vitro study showcases a novel FOA technique by effectively combining robot-guided laser osteotomy with 3D-printed patient-specific implants, eliminating the need for surgical templates and achieving high accuracy in bone cutting and positioning. The workflow holds promise for reducing preoperative planning time and increasing surgical efficiency. Further studies on bone tissue are required to validate the safety and effectiveness of this approach, especially in addressing the challenges of pediatric craniofacial surgery.

3D Printing in Surgery: Transforming Patient-Specific Solutions

The integration of 3D printing technology into surgery represents a transformative shift in modern medicine. Initially used for industrial prototyping, 3D printing has evolved into a critical tool for creating patient-specific implants, models, and surgical instruments, enhancing precision, personalization, and surgical outcomes. This review examines the evolution of 3D printing in surgery, focusing on its applications in surgical planning, custom implants, and bioprinting. Key techniques such as stereolithography (SLA), selective laser sintering (SLS), and fused deposition modeling (FDM) are discussed, alongside emerging bioprinting developments. The review highlights the significant benefits of 3D-printed, patient-specific solutions in orthopedic, craniofacial, and prosthetic surgeries, where traditional mass-produced tools often fail to match individual anatomy, leading to complications. Despite its advantages, 3D printing faces challenges such as high costs, regulatory complexities, and material biocompatibility concerns. Continued advancements in materials science, cost reduction, and regulatory frameworks are necessary for broader clinical adoption.

Understanding the Impact of Ergonomic Practices on Musculoskeletal-Related Symptoms and Emotional Wellness in Craniofacial Surgeons.

A systematic review conducted in 2017 found that Musculoskeletal (MSK) injuries were prevalent among surgeons. Few studies have assessed the role that poor surgical ergonomic practices have had in the development of MSK injuries in plastic and reconstructive surgery (PRS), and fewer specifically in craniofacial surgeons. The impact that MSK injuries have on the emotional well-being of craniofacial surgeons is also not well understood. A branched logic survey with a maximum of 35 questions pertaining to surgical practices, MSK injuries, and emotional well-being was distributed to all active attending physicians who were members of the American Society of Maxillofacial Surgeons (ASMS). The responses were divided into 2 groups, surgeons who reported developing MSK injuries or physical discomfort and those who denied developing MSK injuries or physical discomfort. Data analysis was performed to determine which factors contributed to the incidence of MSK injury and the emotional impact that these injuries had on craniofacial surgeons. A total of 82 active craniofacial surgeons completed responses to the survey for an overall response rate of 16.6%. Of these respondents, 65.9% (n=54) suffered MSK injuries or physical discomfort, and 53.7% (29/54) reported difficulty with either falling asleep or staying asleep because of these symptoms within the last year. Both male and female respondents reported experiencing some level of anxiety or depression because of their MSK injuries. The impact of a MSK injury may impact both physical and emotional wellness of craniofacial surgeons. This study found that a high percentage of craniofacial surgeons have MSK-injuries whereas some have reported a negative impact on their sleep and emotional well-being.

Prenatal to Adulthood: The Responsibility of the Speech-Language Pathologist on the Comprehensive Cleft Palate and Craniofacial Team.

Comprehensive cleft care is an important component when caring for a child with cleft palate with or without cleft lip (CP ± L). Speech-language pathologists (SLPs) serve different capacities on comprehensive cleft palate and craniofacial teams. This tutorial highlights the role of the SLP on the cleft palate and craniofacial team from the prenatal consultation to adulthood. This tutorial emphasizes the importance of collaboration between the cleft team SLP and other professionals on a comprehensive cleft team. Additionally, the tutorial provides education for feeding infants with CP ± L and focuses on assessment and treatment of children with CP ± L before and after the palate repair. Finally, this tutorial underscores the importance of working as part of and collaborating with interdisciplinary team members. SLPs are an essential member of comprehensive cleft teams in addition to other medical providers. SLPs play a critical role on these multidisciplinary teams and are fundamental to the assessment and treatment of feeding, speech, language, and resonance disorders in children with CP ± L. It is critical that SLPs are involved in comprehensive cleft team care from the prenatal consultation through adulthood to monitor resonance, speech, and language development and outcomes.