Cleft Lip and Palate: Current Surgical Management
P re f a c e
C l e f t Li p a n d Pa l a t e : C u r ren t
Surgical Management
Thomas J. Sitzman, MD Jeffrey R. Marcus, MD
Editors
We are honored to bring you this issue of Clinics in
Plastic Surgery focusing on cleft lip and palate.
Whether you are the occasional cleft surgeon look-
ing to stay current, or the senior cleft surgeon
interested in the approaches of your peers, this
issue will reward you with in-depth reviews of
modern cleft care using detailed illustrations to
highlight each surgeons technical approach. The
authors, all recognized experts in cleft surgery,
offer their insights into the complexities of treating
patients with cleft lip and palate so that you and
the field may grow from their experiences.
Readers may ask if any new information exists
in cleft care; the answer is a resounding YES. Our
understanding of genetic contributions to cleft lip
and palate continues to evolve, giving order to
the spectrum of deformities surgeons encounter.
There is growing recognition for the importance
of anatomic reconstruction of the velar muscula-
ture during cleft palate repair. There are new
instruments for measuring speech outcomes,
and a structured approach to managing velo-
pharyngeal insufficiency is evolving. Controversy
Clin Plastic Surg 41 (2014) xixii
http://dx.doi.org/10.1016/j.cps.2014.02.001
0094-1298/14/$ see front matter 2014 Elsevier Inc. All rights reserved.
around naso-alveolar molding grows, accompa-
nied by a resurgent interest in gingivoperiosteo-
plasty. These developments are changing how
we care for all children with cleft lip and palate,
and each is addressed in this issue of Clinics in
Plastic Surgery.
Cleft care continues to advance both in how we
approach all patients and in our understanding
of the nuanced approach necessary for each
patient. This issue includes articles detailing ap-
proaches to patients with 22q11.2 deletion syn-
drome and Pierre Robin sequence. These articles
highlight the unique features of each condition,
including how the treatment approach should be
adapted.
Coupled with the evolution in surgical ap-
proaches, there is a growing appreciation for
the role of outcome measurement in cleft care.
The last two decades have witnessed the birth
of intercenter outcome comparisons, multina-
tional randomized clinical trials, and the incorpo-
ration of outcome reporting into standard care
delivery. Each article in this issue includes a
plasticsurgery.theclinics.com
xii Preface

discussion of appropriate outcome measures, Thomas J. Sitzman, MD

including the what, when, and how of applying Division of Plastic Surgery
them. This information is of widespread impor- Cincinnati Childrens Hospital Medical Center
tance as outcome reporting becomes integrated 3333 Burnet Avenue
with clinical care. Cincinnati, OH 45229, USA
We are grateful to Elsevier for the opportunity to
be guest editors to this issue of Clinics in Plastic Jeffrey R. Marcus, MD
Surgery. We are indebted to each of the authors Duke Cleft and Craniofacial Center
for their valuable contributions, taking time Division of Plastic, Maxillofacial & Oral Surgery
from their professional and personal lives to share Duke Childrens Hospital
their insights. The editorial staff of The Clinics 200 Trent Drive, Erwin Road
is outstanding, in particular, our senior editor, Durham, NC 27710, USA
Joanne Husovski. Finally, we would like to thank E-mail addresses:
our wives and families for their understanding Thomas.Sitzman@cchmc.org (T.J. Sitzman)
and support during this project. jeffrey.marcus@duke.edu (J.R. Marcus)