Audit of a multidisciplinary approach to the care of children with unilateral and bilateral cleft lip and palate

Cleft lip and palate affects the child in many ways, particularly appearanc e, dental arch relationships, growth of the face, and speech development. T he key to successful care is management in a multidisciplinary team adherin g to a well-designed protocol, and careful audit of results. We present the intermediate outcome audit of 15 patients with complete bila teral and unilateral cleft lip and palate whose condition was managed in a multidisciplinary team according to a strict protocol. We give the results observations of operations of a single surgeon's functi onal primary surgery over a 6-year period in terms of dental arch relations hips, cephalometric analyses, aesthetic assessments, and speech analysis. The results show good early facial growth, with dental arch relationships a ppropriate for the age and group; we found only minor speech discrepancies, with no patients requiring pharyngoplasty. The results show the importance of multidisciplinary management, the value of keeping to sound surgical pr otocols, and functional techniques in cleft lip and palate surgery. Our study includes the neglected group of children who have bilateral cleft lip and palate, and it conforms to the style of pan-European projects. (C) 2001 The British Association of Oral and Maxillofacial Surgeons.