Cleft and Craniofacial Disorders | Frequently Asked Questions

While we know how craniofacial anomalies develop, we don’t know exactly why. The facial structures form in the first three months of pregnancy. It is at this time that craniofacial anomalies begin.

It is widely thought that craniofacial anomalies are influenced by factors that include genetics and/or the environment (smoking, substance abuse, vitamin deficiency). We have a geneticist on staff to discuss anomalies related to genetic factors.

Research continues into why these anomalies develop and how to prevent them.

Challenges for most children with a craniofacial abnormality revolve around speech, hearing, feeding, orthodontics, and recovering from reconstructive surgeries. At the Cincinnati Children’s Cleft and Craniofacial Center, we coordinate your child’s care for you. That means if your child needs to be seen by multiple specialists, we’ll arrange that care. Children and teens with a craniofacial anomaly vary in the treatments they need. Specialists commonly involved in evaluating and treating these patients include those in the fields of:

• Audiology
• Dentistry and Orthodontics
• Human Genetics
• Neurosurgery
• Nursing
• Oral and maxillofacial surgery
• Otolaryngology
• Plastic / craniofacial surgery
• Prosthodontics
• Psychology
• Pulmonary Medicine
• Sleep Medicine
• Social Work
• Speech-Language Pathology

The Cleft and Craniofacial Center team work with most of our patients affected with cleft lip and / or cleft palate, Pierre Robin sequence, hemifacial microsomia, Crouzon disease and other related craniofacial conditions.

The Infant and Toddler Genetics Craniofacial Clinic is where newborns, infants and toddlers are evaluated. They are seen by a geneticist and advanced practice registered nurse. This clinic ensures that each child receives appropriate medical and dental management. The team closely monitors growth and development, following these children on a regular basis until they are 3 to 4 years old. They are then referred to the craniofacial team for yearly evaluations until treatment is complete.

The Velopharyngeal Insufficiency / Incompetence (VPI) Clinic evaluates children with velopharyngeal dysfunction (nasal sounding speech) but without a history of cleft palate. A speech pathologist, otolaryngologist and geneticist staff this clinic.

The Orthognathic and Oral Surgery Clinic is held once a month. An oral surgeon and orthodontist evaluate older children who have significant tooth, jaw and mouth abnormalities. These children often require both orthodontic treatment and jaw surgery to correct skeletal misalignment of the teeth and jaws.

Prenatal Counseling
The Human Genetics clinical nurse specialist and geneticist meet with parents who are expecting a baby with a craniofacial condition that has been diagnosed prenatally. Parents are counseled about all aspects of craniofacial care.

Neonatal Airway Management Team
A team of specialists provides consultation and treatment for newborns hospitalized with airway problems such as Pierre Robin sequence.

Feeding Management
Speech pathologists and clinical nurse specialists provide feeding consultation and hands-on instruction for newborns and infants.

Obstructive Sleep Apnea Management
The Pulmonary Medicine doctor on our team assesses children seen in the Cleft and Craniofacial Center clinic who are at risk for obstructive sleep apnea (OSA). Children identified at risk for OSA or other pulmonary concerns are referred to the sleep apnea clinic for further evaluation and management.