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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.
Introduction: A Paradigm Shift in Global Cleft Care
Pages 3-7
Swanson, Jordan W.
Burden of Cleft Disease and Opportunity for Impact
Pages 9-16
Munabi, Naikhoba C. O. (et al.)
Patient Barriers to Care
Pages 17-22
Yao, Caroline A. (et al.)
Innovations in Reaching Patients
Pages 23-31
Baron, Jordana (et al.)
Patterns, Anatomy, and Classification of Clefts
Pages 35-44
Silva Freitas, Renato (et al.)
Early Nutrition, Feeding and Management of Infants with an Oral Cleft
Pages 45-56
Bannister, Patricia (et al.)
Surgical Evaluation, Diagnosis, and Treatment Planning
Pages 57-67
Sierra, Nicolas E. (et al.)
Pediatric and Anesthesiologic Evaluation
Pages 69-80
Kolentz, Anna (et al.)
Anesthesia for Patients with Cleft Lip and Palate
Pages 83-94
Echaniz, Gaston (et al.)
Principles of Cleft Lip Repair
Pages 95-103
Reddy, Sashank K. (et al.)
Unilateral Cleft Lip repair: Rotation-Advancement Technique
Pages 105-118
Chen, Philip Kuo-Ting (et al.)
Unilateral Cleft Lip Repair: Modified Mohler Technique
Pages 119-128
Shen, Chen (et al.)
Unilateral Cleft Lip Repair: Anatomic Subunit Approximation Technique
Pages 129-141
Tse, Raymond W. (et al.)
Bilateral Cleft Lip Repair
Pages 143-150
Chong, David K. (et al.)
Secondary Cleft Lip Repair
Pages 151-163
Rothermel, Alexis (et al.)
Principles of Cleft Palate Repair
Pages 165-176
Rossell-Perry, Percy
Cleft Palate Repair: Early Anterior Palatal Closure and Intravelar Veloplasty Techniques
Pages 177-188
Sommerlad, Brian C.
Cleft Palate repair: Double-Opposing Z-plasty Technique
Pages 189-197
Birgfeld, Craig (et al.)
Palatal Fistulas and Repair
Pages 199-232
Fayyaz, Ghulam Qadir (et al.)
Speech Surgery and Treatment of Velopharyngeal Insufficiency
Pages 233-252
Jackson, Oksana A. (et al.)
Alveolar Bone Graft
Pages 253-269
Swanson, Jordan W. (et al.)
Cleft Rhinoplasty
Pages 271-284
Taylor, Jesse A. (et al.)
Orthognathic Surgery
Pages 285-298
Sierra, Nicolas E. (et al.)
Lateral and Rare Craniofacial Clefts
Pages 299-337
Madaree, Anil (et al.)
Pierre Robin Sequence
Pages 339-350
Rao, Krishna Shama (et al.)
Cleft Dental Treatment and Naso-Alveolar Molding
Pages 353-375
Pannaci, Teresita (et al.)
Cleft Orthodontic Care
Pages 377-404
Arteaga, Vilma L. (et al.)
Speech and Resonance Disorders Secondary to Cleft Lip/Palate (CLP)
Pages 405-418
Kummer, Ann W.
Audiology, Otology, and Airway
Pages 419-432
Vincent, Aurora G. (et al.)
Psychosocial, Educational, and Cultural Aspects of Cleft Care
Pages 433-440
Magee, Leanne (et al.)
Optimizing Postoperative Pediatric and Nursing Care
Pages 441-461
Kuyt, Florence C. (et al.)
Operating Room Function and Biomedical Equipment
Pages 463-477
Flores, David Aldrete (et al.)
Cleft Lip and Palate Simulators in Surgical Training
Pages 481-487
Podolsky, Dale J. (et al.)
Cleft Surgeon Training Models
Pages 489-495
McCullough, Meghan (et al.)
Educator Workshops: Visiting Educators, Curricula, and Digital Education
Pages 497-502
Luan, Anna (et al.)
Educator Workshops: Skills Training
Pages 503-506
Kantar, Rami S. (et al.)
Outcome Assessment
Pages 507-514
Park, Eugene (et al.)
Comprehensive Cleft Care Centers: Scalable, Sustainable, and Cost Effective Surgical Care
Pages 517-529
Campbell, Alex (et al.)
Empowering Local Partners
Pages 531-538
Agrawal, Karoon (et al.)
Short-Term International Cleft Outreach
Pages 539-546
Kanack, Melissa (et al.)
Creating a Culture of Care and Safety
Pages 547-559
Ramly, Elie P. (et al.)
Strengthening Surgical Systems Through Cleft Care
Pages 561-571
Nagengast, Eric (et al.)
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