Complete Cleft Care

Review by S Jarvis
Buckinghamshire, UK

The first few pages of this book reminded me of the principles of astronavigation, with the picture of the night sky and reconstructive flap patterns, mapped out by the author, in the stars. As its title suggests, it is a complete and comprehensive first edition book about the practical management of clefts and velopharyngeal insufficiency in children.

The book contains high quality clinical photographs and line drawings which show the artistry involved in flap design, where “subtle landmarks provide the clues to artful reconstruction”. Cleft lip and palate repairs are discussed, together with the challenge of cleft rhinoplasties. The contents align with UK practice and contain sections on complications, pearls and pitfalls, EBM, recent references and even summaries of Cochrane Reviews. Background information on the genetics, embryology, prenatal diagnosis, counselling and feeding are also included.

The book provides easy access to nine online, mainly surgical videos, of varying quality. Some have no sound and others are probably best watched with no sound, as the background music combined with asynchronous bleeps from the anaesthetic machines makes discussions between the theatre staff difficult to decipher.

Cleft management is becoming more topical in the UK as the incidence is rising, probably due to increased pregnancies in older women and also in young teenagers. Currently cleft palate and/or lip constitute the fourth commonest birth defect. One schoolchild in every school will most likely have some sort of cleft. The book also includes reference to the global humanitarian goals and the cost-benefit for the surgical repair of clefts in developing countries.

The book would be useful for Registrars preparing for the Intercollegiate Examination as the tabulated syndromes and description of Veau’s classification, will make for easier revision for the MCQ and viva questions respectively. The broader implications of clefts, including impaired facial growth, dental anomalies, speech, swallowing disorders and impact on social wellbeing and relationships are also discussed which could also form viva questions.

Overall this is a very good reference book and should be considered valuable reading for anyone involved with the management of cleft children.

Amazon Link: Complete Cleft care
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