Treatment and Surgical Repair for Children Cleft Lip and Palate at the VC HCA
The Centers for Disease Control describes Cleft lip and cleft palate as” birth defects that occur when a baby’s lip or mouth do not form properly during pregnancy. Together, these birth defects commonly are called “orofacial clefts”. These birth defects happen early during pregnancy. A baby can have a cleft lip, a cleft palate, or both a cleft lip and cleft palate. In addition to the visual abnormality caused by Cleft palate, this condition affects children in multiple ways, such as problems with feeding, hearing, dental growth and speaking. While in the mother’s womb, a child undergoes developmental growth, including the fusion of the top palate in the mouth. Children born with cleft palate occur because the fusion process fails to complete; leaving a gap in palate and/or lip.
Services and treatment for children with orofacial clefts vary depending on the severity of the cleft; the child’s age and needs; and the presence of associated syndromes or other birth defects, or both. Surgery to repair a cleft lip usually occurs in the first few months of life and is recommended within the first 12 months of life. Surgery to repair a cleft palate is recommended around 12 months of life. Many children will need additional surgical procedures as they get older. Surgical repair of the lip can improve the appearance of a child’s face and provide function for speech and eating. Surgical repair of the cleft palate is essential for the child to have speech that is understandable and socially acceptable. Children born with cleft lip, cleft palate or both are best served by team care where surgeons, speech pathologists, dental specialists and pediatric medical specialists provide interdisciplinary care from birth through early adulthood.
The cleft lip and palate team of specialists at the Ventura County Health Care Agency, led by plastic surgeon Dr. William Starr, provides coordinated surgical, speech, hearing, dental and ENT follow up services for children born with cleft lip and palate defects. Thanks to this strong team of specialists, children in Ventura County have access to expert multispecialty care to address this developmental disability. No other facility offers these services in Ventura County.
Dr. William Starr is a board certified plastic surgeon with over 35 years of surgical experience treating various pediatric and adult conditions. A tireless advocate for his patients, he provides advanced surgical and cosmetic repair to allow children the opportunity for a normal life. His work not only improves the breathing, hearing and speech impairments caused by cleft palate, but also dramatically improves their appearance and social well-being.
Supporting Dr. Starr in the care of individuals with cleft lip and palate are the Speech-Language Pathologists at the VC HCA. Judith Trost-Cardamone, PhD, CCC-SLP is a nationally recognized expert on cleft palate speech assessment and treatment and Professor Emeritus at California State University Northridge. Dr. Trost-Cardamone provides clinical leadership and direction to the speech therapy team treating children with repaired clefts and related disorders. Working closely with Dr. Starr and the pediatric team, her expertise provides teaching opportunities for her co-workers, medical residents and most importantly the caregivers and families of those patients in recovery.
Other team members are Dr. Robert Bergman, a Board Certified Orthodontist in Camarillo for 30 years, who has been a member of the Ventura County Cleft Lip and Palate Team since its inception in 1989. He is on the faculty at UCLA School of Dentistry and teaches in the Orthodontic department. He provides orthodontic treatment to the cleft patients, improving both their speech and oral facial aesthetics. Dr. Michael Morrissette, a Board Certified Oral & Maxillofacial surgeon, has been a member of the Ventura County Cleft Lip and Palate Team since 1998 providing surgical expertise to correct cleft-related oral and maxillofacial deformities. Coordinating the team since 1991 is Sue Wallace, RN, BSN. She works tirelessly as a Feeding Specialist and administrator to insure that each cleft patient and their family benefits from Ventura County’s cleft-related resources. Dr. Starr, Dr. Morrissette and Sue Wallace travel to South and Central America each year to perform surgeries in third world areas as well as teach other doctors and residents about cleft surgery.
Speech-language pathologist, Denise Milligan, MS, CCC-SLP provides expertise to every one of her patients. A former student of Dr. Trost-Cardamone, she is able to bring high level rehabilitation skills to her patients. Her fluency in Spanish allows her to connect to families with limited English proficiency. She strongly emphasizes the importance of the team approach utilized at the Ventura County Health Care Agency for youngsters with repaired cleft lip and palate as well as for patient care, in general, to provide the best possible communication outcomes. “Children in this program will see the cleft lip and palate team members from the time they are infants to when the rehabilitation process is complete, usually around 21 years. We are a presence in a child’s life into adulthood.” Ms. Milligan singles out core team members Dr. Bill Starr, Sue Wallace, and Judith Trost-Cardamone, SLP, PhD, as contributing to the success of patient outcomes. She states “having a wide range of experts on the team is necessary for having the most successful rehabilitation process. To operate a complex interdisciplinary program such as this, it is essential to have great teamwork and coordination.”