The only nationally certified team in the state collaborates for cleft care in children – Picayune Item
JACKSON, Mississippi – Cooper Beall consults with eight specialists from Children’s of Mississippi, including experts in plastic surgery, oral-maxillofacial surgery, dentistry, orthodontics, audiology, genetics, social work, and speech-language pathology.
Now he can see them all in one visit. Mississippi’s only cleft team with approval from the American Cleft Palate-Craniofacial Association runs a twice-monthly multidisciplinary clinic at the Eli Manning Clinics for Children at the state’s only children’s hospital.
Cooper was born with a bilateral cleft lip and palate, the most severe cleft. Since his birth, he has undergone more than 10 surgeries, with more in his future.
“During the first few days I thought it was more of a cosmetic problem than anything else, but it’s more complex than that as I quickly learned,” said her mother, Taylor Beall. of Vicksburg. âHis condition affected his diet, his speech, his ears (including his hearing), his teeth and his appearance. Cooper’s case was far from just a quick lip repair after birth. His condition will require medical attention until adulthood.
Cooper has been part of the Children’s of Mississippi family since birth, said Dr. Ian Hoppe, chief surgeon at the Children’s of Mississippi and leader of the cleft team. “Her family has been very supportive and an integral part of her care team, which includes experts from the University of Mississippi Medical Center.”
ACPA certification requires access to a multidisciplinary team including a surgeon trained in transcranial craniomaxillofacial surgery, a neurosurgeon, a psychologist for neurodevelopmental and cognitive assessment, an ophthalmologist, a social worker, a geneticist, a speech therapist, a dentist and an orthodontist.
Children born with cleft lip, palate, and facial clefts may have difficulty breathing and feeding, and later speaking. Patients with rare clefts involving the eye also need eye care.
âThe ACPA approval standards are high so we are proud to be an ACPA approved slot team,â Hoppe said. âUMMC’s resources allow us to provide the full range of care needed for patients born with cleft lip, cleft palate and complex facial clefts. “
According to the United States Centers for Disease Control and Prevention, about one in 1,600 babies is born with a cleft lip and palate. Complex facial clefts are very rare and their prevalence is not well understood.
Children born with a cleft lip, cleft palate and facial clefts need care from a variety of specialists throughout their childhood and into their teens, Hoppe said. The Multidisciplinary Cleft Clinic at the Children’s of Mississippi has them all.
âBabies with cleft lip and palate can have feeding problems, so we have a feeding specialist on our team. Children who have surgery for their clefts need pediatric anesthesiologists to put them to sleep because of the unique abnormalities their airways can present. They are therefore part of our team and with each surgery we perform.
Around the age of 18 months to 2 years, children born with clefts start seeing speech-language pathologists, and it is important that their speech-language pathologists “know how to care for children with clefts,” Hoppe said. “Our speech-language pathologist Kara Gibson specializes in split patients.”
Eating and talking have been the biggest functional hurdles for Cooper, Beall said.
âSplit children tend to have feeding problems,â she said. âFortunately, we had the best support with Kara Gibson and Dr Hoppe, helping us overcome every problem. He started speech therapy at the age of 3, due to delayed speech and articulation. Dr. Hoppe has worked diligently to ensure that Cooper has the structure to create the sounds necessary for normal speech. â¦ It boosted Cooper’s confidence to talk to people and helped him read and articulate.
As patients with clefts grow older, they need frequent dental checkups, as clefts can make dental hygiene more difficult. âIt is important for these patients not only to have a pediatric dentist, but also a dentist who is experienced in caring for children with clefts,â he said.
Children born with clefts have surgery on the clefts in the gum tissue before their adult teeth begin to grow.
âCooper is getting to the point where his hard tissue structures (maxilla and mandible) will need to be treated,â said Dr. Ravi Chandran, director of oral-maxillofacial surgery at UMMC’s School of Dentistry.
The surgery will involve grafting bone from her hip to the cleft in her palate. Hoppe and Chandran will perform the procedure together.
Later, Cooper will need orthodontic alignment and orthognathic surgery on his jawbone.
âIt’s a clear example of the interdisciplinary approach,â Chandran said. âIt will involve plastic surgery, orthodontics, oral, maxillofacial surgery and pediatric dentistry. “
Child psychologists on the team research any developmental issues, and social workers make sure patients’ families have resources ranging from food and transportation to educational assistance.
“A lot of our families are doing well,” said social worker Brittannie Goodman, “but if they need anything, we are there for them and can connect them with resources.”
The Children’s of Mississippi’s Multidisciplinary Cleft Clinic can be a “center where families can connect to be referred to otolaryngologists, ophthalmologists, neurologists, orthopedists.
After seeing the day’s patients, members of the slot team work together, share their perspectives on each patient’s condition, and together plan future care.
âBeing able to collaborate as a team gives us insight into each patient’s condition and how we can work together to provide the best care for them,â Hoppe said. âWith our multidisciplinary clinic, we can provide patients with all the expert care they need in one place. “