Our Summary

This research paper studied the training experiences of surgeons in the United Kingdom who specialize in cleft lip and palate (CL/P) repair, specifically a technique called Sommerlad radical intravelar veloplasty (IVVP). Despite similar training and protocols, there are still variations in speech outcomes among different centers.

The researchers conducted interviews with 14 cleft consultants, either in person or via video conferencing, and analyzed the data to understand what was important during their training, as well as their approaches to teaching others.

They found seven key themes, three of which were discussed in detail: Learning to perform palate repair, Teaching others to perform palate repair, and Ongoing learning as a consultant.

The study concluded that cleft palate repair is a complex procedure to learn and teach, with potential for harm if done incorrectly. However, improvements have been made to increase exposure to palate surgery, encourage practice outside of patient operations, and enhance supervised practical experience. The role of colleagues, particularly as mentors and sources of support, was highlighted as extremely valuable. The study provides recommendations to further improve the training experience and ensure equal opportunities for all trainees.

FAQs

  1. What is the Sommerlad radical intravelar veloplasty (IVVP) technique in cleft lip and palate repair?
  2. What were the key themes discovered from the interviews with cleft consultants?
  3. What improvements have been made to increase exposure to palate surgery and enhance supervised practical experience?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cleft palate surgery is to follow post-operative care instructions closely, including maintaining proper oral hygiene, attending follow-up appointments, and avoiding certain foods or activities that may hinder the healing process. It is also important to communicate any concerns or questions with your healthcare provider to ensure the best possible outcome.

Suitable For

Patients who are typically recommended cleft palate surgery are those born with a cleft lip and/or palate, which can affect their ability to eat, speak, and breathe properly. Cleft palate surgery is usually recommended in infancy or early childhood to help improve speech development, prevent issues with feeding and nutrition, and improve overall facial appearance.

Children with cleft palate may also require additional surgeries as they grow older to further improve speech, correct any residual issues with the palate, and address any dental or orthodontic problems. A multidisciplinary team of healthcare professionals, including surgeons, speech therapists, dentists, and psychologists, work together to provide comprehensive care for patients with cleft palate.

Overall, cleft palate surgery is recommended for patients who are experiencing functional difficulties due to their cleft palate, and the goal of surgery is to improve their quality of life and overall health outcomes.

Timeline

Before cleft palate surgery:

  • Patient is diagnosed with cleft palate either prenatally or shortly after birth
  • Patient undergoes various assessments and evaluations to determine the severity of the cleft and any associated issues
  • Patient may receive preoperative counseling and support to prepare for surgery
  • Patient may undergo other procedures or therapies to address any related concerns, such as feeding difficulties or speech delays

After cleft palate surgery:

  • Patient undergoes the surgical procedure to repair the cleft palate
  • Patient may experience pain, swelling, and discomfort in the days following surgery
  • Patient may need to follow a specific diet or feeding plan to aid in healing
  • Patient may require speech therapy or other interventions to address any speech issues post-surgery
  • Patient will have follow-up appointments with their surgeon and other healthcare providers to monitor healing and progress
  • Patient may require additional surgeries or treatments in the future to address any ongoing concerns related to the cleft palate

Overall, the timeline of a patient’s experience before and after cleft palate surgery is a complex and individualized process that involves a multidisciplinary team of healthcare professionals working together to provide the best possible care for the patient.

What to Ask Your Doctor

  1. What specific technique will be used for my cleft palate surgery (e.g. Sommerlad radical intravelar veloplasty)?
  2. What are the potential risks and complications associated with the surgery?
  3. How long will the recovery process be and what can I expect in terms of pain and discomfort?
  4. What are the expected outcomes in terms of speech improvement and cosmetic appearance after the surgery?
  5. How many cleft palate surgeries have you performed and what is your success rate?
  6. Will I need additional surgeries or treatments in the future for my cleft palate condition?
  7. What kind of post-operative care and follow-up will be necessary after the surgery?
  8. Are there any dietary or lifestyle changes I should make before or after the surgery?
  9. How soon after the surgery can I resume normal activities, such as eating and speaking?
  10. Are there any support groups or resources available for patients undergoing cleft palate surgery?

Reference

Authors: Butterworth S, Hodgkinson EL, Stock NM, Sainsbury DCG, Hodgkinson PD. Journal: Cleft Palate Craniofac J. 2023 Feb;60(2):197-210. doi: 10.1177/10556656211058443. Epub 2021 Nov 17. PMID: 34786999