The craniofacial team

The treatment of these disorders requires the involvement of experts from multiple medical and surgical specialties (disciplines). The American Cleft Palate-Craniofacial Association and other cleft palate associations worldwide agree that management of patients with craniofacial anomalies is best provided by a multidisciplinary team of specialists.

When should my child see a craniofacial team?

The optimal time for the first evaluation is within your child's first few weeks of life. The focus of the team visit is to help correct your child's physical problems, as well as facilitate adaptation at each stage of life. Usually, your child will be seen at frequent intervals as an infant and then on an annual, or semi-annual basis thereafter.

The craniofacial anomaly treatment team:

There may be many people involved in the management of craniofacial anomalies for your child, because the skills of many different areas are needed to help with the problems that can occur. The following are some of the members of the craniofacial team:

• plastic/craniofacial surgeon - a surgeon with specialized training in the diagnosis and treatment of skeletal abnormalities of the skull, facial bones, and soft tissue; will work closely with the orthodontists and other specialists to coordinate a surgical plan.
• neurosurgeon - a surgeon who specializes in the brain, spinal cord, and nerves; also coordinates all surgical interventions of head abnormalities with the craniofacial surgeons (i.e., craniosynostosis).
• pediatrician - a physician who will follow your child as he/she grows and help coordinate the multiple specialists involved.
• orthodontist - a dentist who evaluates the position and alignment of your child's teeth and coordinates a treatment plan with the surgeon and other specialists.
• pediatric dentist - a dentist who evaluates and cares for your child's teeth.
• speech and language specialist - a professional who will perform a comprehensive speech evaluation to assess your child's communicative abilities and who will closely monitor your child throughout all developmental stages.
• otolaryngologist (ear-nose-throat specialist) - a physician who will assist in the evaluation and management of ear infections and hearing loss that may be side effects of your child's cleft abnormality.
• audiologist (hearing specialist) - a professional who will assist in the evaluation and management of any hearing difficulties your child may have.
• ophthalmologist - a physician who specializes in the structures, functionality, and diseases of the eye. An ophthalmologist evaluates and plans treatment of associated eye problems in coordination with other surgical interventions.
• genetic counselor - a professional who reviews the medical and family history, as well as examines your child to help in diagnosis. A genetic counselor also counsels your family regarding risk for recurrence of craniofacial abnormalities in future pregnancies.
• nurse team coordinator - a registered nurse who combines experience in pediatric nursing with specialization in the care of your child, and acts as liaison between your family and the craniofacial team.
• social worker - a professional who provides guidance and counseling for your child and your family in dealing with the social and emotional aspects of a craniofacial abnormality and assists your family with community resources and referrals (i.e., support groups).
• psychiatrist - a physician who assesses the psychosocial function and behavioral development of your child. The psychiatrist will assist the family in identifying therapy resources and coordinates referrals with the social services department.