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This one is about: How to Choose Your Cleft Surgeon

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by Dr Craig Senders, Dr Markoe F Dugan and Dr Jonathan Sykes

Choosing your cleft surgeon is one of the many important decisions a parent must make when their child is born with a cleft. Most families follow the recommendation of their primary care physician in choosing a cleft surgeon. However, in many communities there is more than one qualified cleft surgeon. Therefore, most families have the option of selecting the surgeon which will best meet the needs of their child and their family.

The care for most patients with a cleft should be coordinated by a multi-disciplinary team. Team members include cleft surgeons, speech pathologists, otolaryngologist/head and neck surgeons (ENT), pediatricians, orthodontists, oral surgeons, social workers, geneticists and other specialties when needed. As the care of a child with a cleft is 
quite complex, a joint effort ensures comprehensive care for your child. In selecting a cleft surgeon, it is highly advantageous to choose a surgeon who is an active member of a cleft and/or craniofacial team.

There are many types of surgical specialists that perform cleft surgery, including: Facial Plastic Surgeons, Oral and Maxillofacial Surgeons, Otolaryngologists/Head and Neck Surgeons, Pediatric Surgeons, and Plastic Surgeons. The training for each of these specialties provides exposure to the area of cleft lip and cleft palate. However, completion of training in any of the above specialties does not guarantee clinical expertise.

The essential ingredients for a cleft surgeon are: training and experience, commitment to clefts and willingness to work with a cleft team. Board Certification in the surgeon's primary field is a starting point. Additionally, it is important to determine what training your surgeon has received in clefts, as well as the number of cleft surgeries they perform each year. You may wish to ask your surgeon whether they have attended a recent annual meeting of the American Cleft Palate/Craniofacial Association (ACPA/CFA), or other meetings specifically dedicated to clefts. Surgeons with a strong interest in clefts would be active members of a cleft or craniofacial team, would be members of the American Cleft Palate/Craniofacial Association (ACP/CFA)* and would be recognized by Crippled Childrens Services in their State as a qualified surgeon.

Even with the changing health care environment, most families should be able to choose from more than one qualified surgeon. In selecting your cleft surgeon, the most important factors should be experience, commitment and team work.

* For a listing of the physicians in your area who are also members of ACPA/CFA, call Cleftline at 1-800-24-CLEFT.

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