ABSTRACT
The fourth paper in this series on cleft lip and palate discusses the surgery involved in the care of children and young people with clefts of the lip and/or palate, orthodontic treatment and psychological support for this group of patients and their families.
Subject(s)
Aftercare/organization & administration , Cleft Lip/surgery , Cleft Palate/surgery , Continuity of Patient Care/organization & administration , Perioperative Care/organization & administration , Adult , Child , Cleft Lip/psychology , Cleft Lip/rehabilitation , Cleft Palate/psychology , Cleft Palate/rehabilitation , Humans , Infant , Orthodontics, Corrective , Orthognathic Surgical Procedures , Patient Care Team , Plastic Surgery Procedures , Social SupportABSTRACT
The third paper in this series on cleft lip and palate gives an overview of feeding a baby with a cleft lip and/or palate. It includes a description of the feeding assessment that all babies receive from the Cleft Specialist Nurse, the different methods of feeding that are likely to succeed with each cleft type, and other associated care and interventions.
Subject(s)
Bottle Feeding/methods , Breast Feeding , Cleft Lip/nursing , Cleft Palate/nursing , Bottle Feeding/instrumentation , Bottle Feeding/nursing , Cleft Lip/complications , Cleft Palate/complications , Feeding Behavior , Humans , Infant , Infant Food , Nurse Clinicians , Nursing Assessment , Oral Hygiene , Pierre Robin Syndrome/complications , Sucking Behavior , WeaningABSTRACT
Cleft lip and/or cleft palate affects about 1:700 babies born in the UK and may occur as a single anomaly or in association with other congenital abnormalities as part of a syndrome. This article, the first in a series, provides a brief overview of the different types of cleft lip and palate and describes the organisation of regional cleft services in England and Wales.
Subject(s)
Cleft Lip , Cleft Palate , Abnormalities, Multiple/classification , Abnormalities, Multiple/epidemiology , Abnormalities, Multiple/genetics , Abnormalities, Multiple/therapy , Child Health Services/organization & administration , Cleft Lip/classification , Cleft Lip/epidemiology , Cleft Lip/genetics , Cleft Lip/therapy , Cleft Palate/classification , Cleft Palate/epidemiology , Cleft Palate/genetics , Cleft Palate/therapy , Critical Pathways/organization & administration , DiGeorge Syndrome/genetics , England/epidemiology , Humans , Infant, Newborn , Patient Care Team/organization & administration , Pierre Robin Syndrome/genetics , State Medicine/organization & administration , Wales/epidemiologyABSTRACT
The second in a series on cleft lip and palate, this article outlines the diagnosis of these congenital anomalies, the problems that a child with a cleft lip and/or palate and their family may encounter in the first five years of life, and the multidisciplinary care needed. The input of individual members of the cleft team is described, including nurse specialists, speech and language therapists, paediatric dentists, ear, nose and throat surgeons, and audiologists.
Subject(s)
Cleft Lip/physiopathology , Cleft Palate/physiopathology , Abnormalities, Multiple , Child, Preschool , Cleft Lip/diagnosis , Cleft Lip/genetics , Cleft Palate/diagnosis , Cleft Palate/genetics , Feeding and Eating Disorders of Childhood/physiopathology , Hearing Disorders/physiopathology , Humans , Infant , Infant, Newborn , Nursing Assessment , Prenatal Diagnosis , Speech Disorders/physiopathology , Tooth Diseases/physiopathologyABSTRACT
OBJECTIVE: Pierre Robin sequence (PRS) involves the triad of micrognathia, glossoptosis, and cleft palate. Neonates with PRS suffer from two problems--airway obstruction and feeding difficulties--but the severity of these problems varies greatly. The resultant varying definitions of PRS have resulted in inconsistent management of those babies given the diagnosis. This in turn makes comparison of published data and communication between clinicians difficult. Historically at Birmingham Children's Hospital, the cleft team only identified babies presenting with cleft palate and severe respiratory distress as "true" PRS. These babies were admitted to the high-dependency neonatal ward for airway assessment and management. Babies with a mild degree of respiratory obstruction but who were managed successfully at home were not classified as having PRS despite needing considerable input from the Cleft Clinical Nurse Specialist. A system of classifying babies with PRS based on the severity of their symptoms and signs and treatment required was therefore devised and is described in this paper. RESULTS: Since implementation, this new classification of babies with PRS into three grades has clarified care pathways and enhanced communication between the Cleft Clinical Nurse Specialists and other health professionals involved with the care of these babies.