Cleft and Craniofacial SA

Craniofacial surgery is concerned with the treatment of patients with rare and/or complex congenital or acquired anomalies which together affect the head and face.

Many people require treatment and support from birth to adulthood. Cleft and Craniofacial SA treats both children and adults.

Cleft and Craniofacial SA treats people with a wide range of craniofacial disorders such as:

• Distortion of the skull and facial shape (craniosynostosis)
• Cleft lip and palate deformities through to deep facial clefts
• Facial growth anomalies
• Tumours which require removal followed by reconstructive work
• Trauma cases that require reconstruction.

Some conditions are present at birth, while others, such as tumours and malignant growths, may develop in later life.

The unit was established in 1975 as the Australian Craniofacial Unit and has played a role in training and developing surgeons from units across the country and overseas.

In September 1988 the Australian Health Ministers' Advisory Council officially designated the Unit a National Centre of Excellence.

In 2020 the unit’s clinicians identified a need to rename the service to better encompass the service’s current role and reflect its contemporary practices.

A rebrand enables to unit to differentiate itself ensuring consumers and donors are able to readily identify the services of the WCH team.

The clinicians felt that Cleft and Craniofacial SA was a modern interpretation of the existing brand and better encompasses the unit’s position as one of a number of highly regarded units across Australia.

For patients and visitors needing a place to stay, there are many accommodation choices close to the Hospital.

Treatment may span many years and is usually a combination of surgery and medical management undertaken at predetermined stages.

Inpatients at the Women's and Children's Hospital are usually cared for on one of two specialist wards:

• Rose Ward
  A 17-bed medical/surgical ward that primarily looks after babies from birth to 12 months.
• Kate Hill Ward
  Babies, children and adolescents needing complex surgery are cared for in Kate Hill Ward.

If your child only requires Day Surgery, they will attend the Day of Surgery Admissions.

For more information about your child having surgery at the WCH, go to If Your Child is Having Surgery.

The newly named Cleft and Craniofacial SA (C&CSA) believes that a multidisciplinary approach is the cornerstone of patient care and provides the best outcome for patients with Craniofacial disorders. This approach gives an opportunity for all aspects of patient care to be considered when making decisions regarding future treatment and resultant outcomes. The Multidisciplinary Clinic provides the forum for this process to occur.

What is the Multidisciplinary Clinic?

The Clinic is a forum or meeting to allow all people involved with a patient to give their assessments and/or opinions on the treatment of the patient attending the clinic, and to allow patients or parents to ask any questions about the treatment or management. We have two multidisciplinary clinics named the Craniofacial Clinic and the Cleft Lip and Palate Clinic.

Why have a Multidisciplinary Clinic?

The Clinic provides an opportunity for any of the people involved in the present or future management of a patient with a Craniofacial disorder to share information, e.g. to give an assessment of the patient, suggest a treatment programme, determine the timing of future treatment, to clarify any difficulties or differences which may arise from different assessments. In this way everyone involved with the patient is fully informed about their total management.

The Clinic provides the opportunity for patients/parents to make sure they understand what will be happening with regard to treatments, treatment outcomes, time of treatments etc. or to ask any questions about anything which has not been covered.

Where is the Clinic held?

At the Cleft and Craniofacial SA Unit of the Women's and Children's Hospital.

How frequently are clinics held?

Clinics are held twice a month.

Do I have to attend every month?

No. Patients only attend a Clinic when their case is to be reviewed. The frequency of Clinics for each patient depends on their current treatment plan and when it is to be reviewed – usually about once per year.

Who can attend the Clinic?

The patient. It is essential that the patient is present at the Clinic.

Parents and caregivers of the patient concerned.

All people (or their representative) involved in the assessment and treatment of the patient attending the clinic.

Parents may also invite any other interested person/s to assist them or support them in their understanding of the Craniofacial disorder or the treatment involved.

How does the Clinic run?

In the weeks before the Clinic appointment:

A series of appointments are made with various specialists. The specialists will assess the patient’s progress and suggest possible treatment .

On the day of the Clinic appointment:

Each patient is allocated a 15 minute appointment – but more time will be taken if necessary.

Everyone who has assessed the patient gives a report of the assessment and treatment possibilities. These assessments are discussed by the clinic to clarify any problems which may alter the eventual treatment or the timing involved. These reports are discussed before the patient is present to enable the reports to be summarized for the patient.

The patient and support persons are then given a verbal summary of the reports and have an opportunity to ask any questions about patient care (Parents will also have had an opportunity to ask questions and clarify concerns at the longer appointments earlier in the week).

As a result of this discussion there may be a review of treatment or the timing of the treatment.

The Clinic is therefore the opportunity to voice concerns, check on times, and clear up anything at all that is not understood or may appear to have changed.

A written record is kept of each clinic appointment and a summary can be made available to the referring doctor.

What disciplines are involved with the Cleft and Craniofacial SA Team?

Any of the following may be involved in the assessment and/or treatment of patients attending the Craniofacial Unit.

• Craniofacial Surgeon
• Neurosurgeon
• Plastic Surgeon
• ENT Surgeon
• Ophthalmologist
• Medical Geneticist
• Anaesthetist
• Paediatric Chest and Sleep Physician
• Radiologist
• Social Worker
• Psychiatrist
• Psychologist
• Occupational Therapist
• Cardiologist
• Speech Pathologist
• Dentist
• Orthodontist
• Nursing Staff
• Secretarial Staff and Voluntary Workers.

WCH-related links

• WCH Foundation
• Starlight Foundation
• Aboriginal Liaison Unit
• Clown Doctors – includes video

Other websites

• Cleft Lip and Cleft Palate Scheme – Australian Government
• CleftPals Victoria – Helping those with, and affected by, cleft lip and palate
• Australasian Cleft Lip & Palate Association Inc.
• Craniofacial Australia
• The Children's Craniofacial Association
• FACES – The National (USA) Craniofacial Association
• John Hopkins Cleft and Craniofacial Center