Simple to complex cleft and craniofacial issues

The cleft and craniofacial clinic at Children’s welcomes babies, children, teens and even young adults with simple to complex conditions, including:

• Cleft lip, an opening in the upper lip
• Cleft palate, an opening between the mouth and nose a premature fusion of the bones of an infant’s skull
• Craniosynostosis, a premature fusion of the bones of an infant’s skull
• Submucous cleft palate, a type of cleft palate
• Facial asymmetry, features on a child’s face that are out of balance
• Oculoauriculovertebral (OAV) syndrome, a condition that affects the head, neck and spine
• Pierre Robin sequence, a condition that involves the lower jaw and a cleft palate
• Treacher Collins syndrome, a condition that affects facial bones and tissues
• Plagiocephaly, or abnormal head shape
• Torticollis, a neck deformity
• 22q11.2 deletion/ Velocardiofacial Syndrome/ DiGeorge Syndrome, a complex condition that may include cleft palate, heart defects and distinct facial features/appearance
• Other conditions that impact craniofacial development

Specialized Cleft and Craniofacial Treatment

• Surgical repair of cleft lip and cleft palate
• Longitudinal dental and orthodontic consultation for management of complex dental issues that often accompany cleft and craniofacial conditions
• Jaw (orthognathic) surgery if needed
• Specialized speech and language evaluation and treatment
• Psychosocial support services
• Audiology evaluation and hearing aid fitting and programming when needed
• Facial plastic and craniofacial surgery

Cleft Lip and Palate Clinic

Cleft Lip and Palate is a common congenital anomaly that results in an opening in the lip, the mouth, or both.  Children with cleft lip and/or cleft palate will require surgery to repair the cleft lip and cleft palate and often require orthodontic treatment and oral surgery. They may need assistance with feeding as an infant and speech therapy and often have middle ear dysfunction.

The first year: We will partner closely with parents and meet babies born with cleft lip and/or palate in the first few weeks to help to ensure that the baby is feeding well and to establish a surgical plan for the first year.  We recommend frequent weight checks for the first few months.  Most children will have their lip and palate repaired, and ear tubes placed before their first birthday.

After the first year: Our multidisciplinary cleft lip and palate clinic follows patients from toddlers through young adults for concerns related to clefting, including lip and nose appearance, speech, hearing, and dentition.  Cleft Lip and Palate Clinic is typically a full day evaluation.  Patients leave clinic that day with a plan in place for the next year, and potentially for years to come.  The Cleft Lip and Palate Clinic is offered at our Minneapolis and St. Paul campuses.

Plagiocephaly Clinic

Children’s offers a comprehensive multidisciplinary plagiocephaly clinic to evaluate and treat infants when there is concern regarding head shape. Members of our comprehensive plagiocephaly team include: the Craniofacial Surgeon, craniofacial nurse practitioner, physical therapist, and certified orthotist who is available on-site to fashion a molding helmet should that be necessary.  Plagiocephaly refers to the flattening of a baby’s head, and can be influenced by time spent lying on the back, or by weakness in the neck muscles. Children with plagiocephaly may benefit from physical therapy to strengthen the neck.

Early recognition is important so parent education and treatment can be initiated. We stress “tummy time” and decreased pressure on the head by placing the infant on the tummy as often as possible while awake.

Occasionally an infant’s skull is significantly misshapen and does not respond to these conservative measures. In this case the child will benefit from evaluation at our Plagiocephaly Clinic to determine additional treatment options.

Infants are evaluated in our Plagiocephaly Clinic as soon as abnormal head shape is identified. At this evaluation, the head is carefully measured and compared to established normal measurements. Our physical therapist also conducts a formal and thorough evaluation of the neck range of motion and neck strength. Surgical treatment is rarely recommended by our plagiocephaly team. We meet our patients’ goals through therapy and helmeting.

The care team consists of a nurse practitioner, a physical therapist and a certified orthotist.  The Plagiocephaly clinic is offered at three locations:  Minneapolis, Minnetonka and St. Paul campuses.

Craniosynostosis Clinic

Children’s offers a comprehensive, multidisciplinary craniosynostosis clinic, which is the first of its kind in the region.  This team is designed to care for the complex syndromic patients with craniosynostosis as well as the more straight forward single-suture cases of craniosynostosis. Members of this pediatric team include the craniofacial surgeon, neurosurgeon, craniofacial nurse practitioner, physical therapist, and developmental neuropsychologist.   The clinic is offered at our St. Paul and Minneapolis locations.

We offer full service care for the craniosynostosis patient including physical therapy, open cranial vault remodel and cranioplasty surgery, endoscopic minimally invasive repair of craniosynostosis and helmet molding therapy when indicated. Patients benefit greatly from the multidisciplinary care to develop an individual treatment plan for each patient. We follow these patients over the course of their childhood into adolescence and closely monitor growth and development.  We are able to provide families with assistance in obtaining any necessary referrals and services to optimize each child’s neurologic well being.  We are currently studying the long-term neurologic and cognitive development of these patients. Our craniosynostosis team is engaged in research on minimally invasive techniques and reducing surgical blood loss and transfusions during cranial vault remodel surgery.