Orofacial clefts represent the most common congenital craniofacial anomaly worldwide. This condition is best managed by an interdisciplinary team of specialists, often with gratifying results for both the patient and the care providers. Despite recent advances in the management, it remains a challenge today to provide cleft care in low- and middle-income countries (LMIC) due to the lack of basic health care infrastructure and long-term follow-up. International cleft mission trips have traditionally been successful in providing reconstructive plastic surgery to communities with limited resources. More recently, there has been a global effort in the cleft care community to facilitate development of sustainable local cleft care centers that are capable of providing longitudinal, comprehensive care to the indigenous population. This chapter focuses on the elements that are necessary for running a successful international cleft mission and a local cleft care facility, which include the essential personnel, operational protocols, equipment, logistics, patient selection, and follow-up. The challenges and future directions of providing cleft care in LMIC are also discussed.

Cleft lip and palate represents the most common congenital facial anomaly. Congenital anomalies are one of the top 10 causes of disability and suffering in many low and middle income countries (LMICs.) Further, an estimated 30% of the global burden of disease is treated primarily through surgery, and among surgical conditions, treating clefts conveys disproportionately large benefit relative to cost because suffering can be halted at a young age and deliver a lifetime of health. Over the last 50 years, cleft care has advanced in low-resource settings through international surgical missions and the efforts of sparse local providers. While exciting anecdotes of impact abound from these efforts, recent studies have identified a complication rate that often exceeds 50% and there is concern about the sustainability of foreign volunteer missions. This book serves as a thorough resource for providing medical and surgical care of cleft lip and palate deformities in low-resource settings, geared to the context of those settings. The content is consensus-based and evidence-based, with emphasis on treatment that is appropriate to a low-resource context and how this differs from that in higher-resource environments. It is authored by recognized cleft experts in close partnership with providers who practice in low-resource settings. It is heavily pictorially based through illustrative figures, photos and diagrams, to be facile for those who speak English as a second language. Following the introduction, Complete Cleft Care in Low-Resource Settings has six main sections: patient workup, surgical treatment, comprehensive care, educational innovation, care delivery models, and finally a series of illustrative case studies. Uniquely, the book’s breadth encompasses cleft care comprehensively, but does so through a practical “how to” format with many “from the field” examples of what has worked.

In Designing Strategies for Cleft Lip and Palate Care it was aimed to link the epidemiology from different areas in the world with the interspecialty surgical care and the future genetic research projects. The objective is to concisely discuss the methodology of interspecialty care and stimulate future ideas for prophylactically managing or preventing such deformities. I am confident that one day the surgical interventions that bombard the patients from the day of newborn delivery and throughout the years of youth should be significantly decreased based on the genetic prophylactic intervention, probably.

Packed with original color illustrations and videos, Interdisciplinary Cleft Care: Global Perspectives draws from the rich national and international relationships between the Global Smile Foundation and world experts in cleft care to provide comprehensive, clear, and user-friendly content for all cleft care professionals. This text is designed to be an inclusive resource that addresses the educational needs of all cleft care providers, from novice learners looking to develop their area’s first multidisciplinary cleft team to seasoned specialists looking to improve their outcomes. While most other educational cleft care books on treatments and techniques are relevant in high-resource settings, they may not be applicable in low and middle-income countries where orofacial clefting is most common. Interdisciplinary Cleft Care: Global Perspectives details multiple treatment modalities and surgical techniques that can be applied in low, medium, and high-resource settings alike for all key challenges in cleft care. This book has a team-based framework with chapters that address pertinent topics in cleft care by national and international authorities on the subject from plastic surgery, facial plastic surgery, pediatric otolaryngology, oral maxillofacial surgery, speech-language pathology, dentistry, orthodontics, psychology, and more. This text also brings attention to special topics often ill addressed in traditional cleft care resources, including psychosocial issues, safety and preparedness in low-resource settings, and guidance for building a multidisciplinary cleft care team where needed. The book includes access to 60 high-quality surgical videos to support the techniques reviewed in the chapters.

Comprehensive Cleft Care is a complete clinical reference that addresses every aspect of the life-long care required by patients with orofacial clefting. Supported by a handsome full-color presentation, Comprehensive Cleft Care features heavily-illustrated chapters that provide unmatched coverage of everything from prenatal diagnosis to final orthognathic surgery. The inclusion of topics such as basic science research, mission work, and outcome measures make this an all-in-one clinical companion with coverage that cannot be found anywhere else. With its distinct holistic approach and perspectives from skilled specialists in a variety of disciplines, Comprehensive Cleft Care presents an unmatched overview of cleft repair and management. Volume One of the book covers non-surgical issues including: Embryology, Anatomy, Classification, Epidemiology, and Genetics; Nursing topics, Neuropsychosocial and Educational Aspects, Otologic, Audilogic, and Airway Assessment and Management, Outcomes and Research.

Cleft Lip and Palate: Diagnosis and Management is an unparalleled review of treatment concepts in all areas of cleft involvement presented by an international team of experienced clinicians. A unique feature of the book is that it largely consists of longitudinal facial and palatal growth studies of dental casts, photographs, panorexes, and cephalographs from birth to adolescence. Throughout the discussion of growth and treatment concepts, the importance of differential diagnosis in treatment planning is underscored. The underlying argument is that all the treatment goals – good speech, facial aesthetics, dental occlusion, and psychological development – may be realized without the need to sacrifice one for another. This updated third edition includes new chapters on further successful physiological treatment protocols, strategies for coping with psychological effects, the excellent clinical work being undertaken in Asia, future multicenter palatal growth studies, and other topics.