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References

Bender PL Genetics of cleft lip and palate. J Pediat Nurs. 2000; 15:242-249
Gregg TD, Boyd D, Richardson A The incidence of cleft lip and palate in Northern Ireland from 1980-1990. Br J Orthod. 1994; 21:387-392
Jensen BL, Kreiborg S, Dahl E, Fogh-Anderson P Cleft lip and palate in Denmark 1976-1981: epidemiology, variability and early somatic development. Cleft Palate J. 1988; 25:258-269
Amaratunga NA A study of etiologic factors for cleft lip and palate in Sri Lanka. J Oral Maxillofac Surg. 1989; 47:7-10
Hagberg C, Larson O, Milerad J Incidence of cleft lip and palate and risks of additional malformations. Cleft Palate Craniofac J. 1998; 35:40-45
London: HMSO; 1998
Milerad J, Larson O, Hagberg C, Ideberg M Associated malformations in infants with cleft lip and palate: a prospective population-based study. Pediatrics. 1997; 100:180-186
Stoll C, Alembik Y, Dott B, Roth MP Associated malformations in cases with oral clefts. Cleft Palate Craniofac J. 2000; 37:41-47
Lees M Genetics of cleft lip and palate. In: Watson ACH London: Whurr Publishers; 2001
Mars M, Houston WJB A preliminary study of facial growth and morphology in unoperated male unilateral cleft lip and palate subjects over 13 years of age. Cleft Palate J. 1990; 27:7-10
Shaw WC, McWilliam J, Sell D, Murphy T, Mildinhall S, Bearn D A six-center international study of treatment outcome in patients with clefts of the lip and palate. Parts 1-5. Cleft Palate Craniofac J. 1992; 29:393-418
Bearn D, Mildinhall S, Murphy T, Murray JJ, Sell D, Shaw WC Cleft lip and palate care in the United Kingdom - the Clinical Standards Advisory Group (CSAG) study: Part 4. Outcome comparisons, training and conclusions. Cleft Palate Craniofac J. 2001; 38:38-43
Fitzsimons KSD, van der Meulen J, Copley L CRANE Database: Annual Report 2011. 2011;

The management of patients with cleft lip and palate (CLP) part 1. introduction

From Volume 5, Issue 1, January 2012 | Pages 6-8

Authors

Toby J Gillgrass

BDS, FDS(Orth)

Consultant Orthodontist Cleft Lip and Palate, Hon Senior Clinical Lecturer Glasgow University

Articles by Toby J Gillgrass

Alan J Gowans

BDS, FDS(Orth)

Lead Consultant Orthodontist Cleft Lip and Palate (Northern & Yorkshire), Hon Senior Lecturer University of Leeds

Articles by Alan J Gowans

Abstract

This paper provides an overview of the historical background to the delivery of care in the UK of patients with cleft lip and palate and the impact of the Clinical Standards Advisory Group (CSAG) report. The paper explains the way cleft services have subsequently changed and describes the current delivery of care following CSAG recommendations within the multidisciplinary team. Following this introductory paper will be a series of papers dedicated to describing and explaining the different roles of each specialist member of the cleft team and key stages of delivery of care within that team.

Clinical Relevance: Introduction and background into the delivery of care of cleft services in the UK. This is an introductory paper of a series of papers intended to increase the depth and breadth of knowledge of the reader into the specialist areas required in the multidisciplinary approach for the care of patients with cleft lip and/or palate.

Article

The management of patients with cleft lip and palate is both challenging and highly rewarding. The care of this patient group, from the antenatal diagnosis, continues until late adulthood. Close co-ordination between the many specialist areas involved is essential to provide the highest quality of care for the patient.

The prevalence of cleft lip and palate in non-syndromic children is quoted as 1 in 700 live births.1 Cleft lip with cleft palate is the most common presentation in England and Wales, however, cleft lip does vary in prevalence, not only within but also between different racial groups. Males are more commonly affected than females and are more likely to have complete clefts. Unilateral clefts have been found to be most common on the left-hand side.2

Few prevalence studies discriminate between unilateral CLP and bilateral CLP, although a prevalence ratio of 4:1 has been reported.3 The aetiology of cleft lip and palate is still largely unknown, although it is suggested to be epigenetic where several genetic and environmental factors interfere with the morphogenesis resulting in clefting.4

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