CLP Protocol
CLEFT LIP AND PALATE BIRTH TO MATURITY TREATMENT PROTOCOL
Antenatally
It is posible for pre-natal ultrasound to detect the presence of cleft lip and palate. Diagnosis of whether the cleft lip and palate is an isolated finding or syndromic (that is associated with other physical anomalies) is usually attempted pre-natally, but is not always possible.
Consultation with Professor David is undertaken in the prenatal period, so that parents have the opportunity to discuss concerns, likely outcomes and most importantly, what to expect when their baby is born.
At Birth
As soon after birth as possible an appointment will be made to see Professor David and a speech pathologist. The speech pathologist will assist with the feeding process and monitor progress.
| Professor David | Consultation regarding surgical management for repairing the lip, nose and anterior palate |
| ENT Surgeon | Assess ears and establish if grommets are required and insertion of grommets if it is felt necessary |
| Speech pathologist | Review feeding and discuss speech management |
| Dentist | Discuss dental development and care |
| Geneticist | To help understand the cause when CLP is not isolated and to provide information about the possibility of recurrence in future pregnancy |
6 Months
| Professor David | Surgical repair of the palate |
Up til 12 months
| Professor David | Ongoing consultation |
| Audiologist | Assess hearing following surgery |
| ENT Surgeon | Follow up on grommets if inserted or to review progress |
| Orthodontist | Initial consultation and outline orthodontic management |
| Speech Pathologist | Assess speech and language development |
Between the age of 2 and 5
| Professor David | Yearly review and pre surgical management for lip and nose revision |
| ENT surgeon | Yearly review |
| Audiologist | Yearly review |
| Dentist | Yearly review |
| Speech Pathologist | Yearly review |
| Orthodontist | Yearly review |
| Nasendoscopy | If deemed neccessary |
| Radiology | Xrays, to plot the growth of the facial skeleton, these are usually performed just before the age of 5 |
Between the age of 6 and 12
| Professor David | Yearly review and pre surgical management for possible alveolar bone graft |
| ENT surgeon | Yearly review |
| Dentist | Yearly review |
| Speech Pathologist | Yearly review |
| Orthodontist | Yearly review |
| Radiology | Xrays, to plot the growth of the facial skeleton |
Between the age of 13 and 18
| Professor David |
Yearly review |
| Dentist | Yearly review |
| Speech Pathologist | Yearly review |
| Orthodontist | Yearly review |
| Radiology | Xrays, to plot the growth of the facial skeleton |
