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Cleft lip and palate are the most common congenital malformations in the jaw and facial area and affect around one in 700 newborns, whose overall development is nevertheless completely normal in most cases. A cleft occurs between the 6th and 12th week of development because the lip and palate halves do not unite. Surgical closure is performed in the first year of life to allow the nose and mouth to function normally. In the case of unilateral clefts, this has been carried out in Basel since 1991 in just one operation, hence the "single-stage" closure, whereas in the case of bilateral clefts this is sometimes carried out in two stages. Cleft lip and palate treatment is continuously adapted to the latest medical research findings. This is possible mainly thanks to the support of the Botnar Research Center for Child Health and professional exchange with specialist clinics abroad.
Depending on the type of cleft and the age of the child, specialists from different fields are required for the treatment, which we bring together for you at the University Center in a special consultation at the same time. In this way, the individual treatment is discussed on an interdisciplinary basis and optimally coordinated treatment steps are determined for the patient.
As a center, we also offer our specialist expertise at theAarau Cantonal Hospitaland theSt. Elisabethen Hospital in Lörrachand form a supra-regional care network with them
The University Center for Cleft Lip and Palate and Facial Malformations introduces itself in the video:
Forms of appearance (DE/EN/F)
There are different forms and manifestations of cleft formation. The lips, jaw and palate can be affected, either individually or in combination. In the case of cleft palate, a distinction is also made between cleft formation in the hard and/or soft palate. Due to the many different combination forms, there is a variety of individual manifestations. Basically, clefts can be divided into three main groups:
- Cleft lip or cleft lip/jaw
a. Complete or incomplete
b. Unilateral or bilateral - Soft palate or hard and soft palate clefts
a. Complete or incomplete
b. Open or submucosal - Complete cleft lip and palate
a. Unilateral or bilateral - Concomitant malformations
Concomitants and consequences (DE/EN/F)
Depending on the degree of malformation, a cleft lip and palate can impair various functions:
- Nutrition after birth
- Muscle and tongue function
- Middle ear ventilation and hearing impairment
- Speech and language development
- Teeth and dental arch
- Long-term development
Diagnostics and treatment (DE/EN/F)
We offer holistic crevice treatment, i.e. all influencing factors are taken into account. In addition, we strive for one-stage cleft closure wherever possible. This means that the lip and palate are closed in one operation (so-called "one-stage" cleft repair). Together with all the specialties involved, we offer advice and care from the very first moment:
- Prenatal diagnostics and support during pregnancy
- Postnatal care and support after pregnancy
- Insurance benefits
- Operations
- Outpatient follow-up checks
Further measures (DE/EN/F)
In addition to the treatment of cleft lip and palate, there are a number of additional therapies and measures that contribute to optimal healing and development:
- Nutritional support and possible measures after the operation
- Nursing measures
- Therapies
Speech therapy - Function-oriented speech therapy (DE/EN/F)
Speech therapy is part of the interdisciplinary core team and focuses on a holistic approach with an emphasis on a function-oriented treatment approach. The child and his or her current needs are always at the center of our treatment. In particular, we attach great importance to speech and language development that is as inconspicuous as possible, which we regularly assess during our consultations. Parents are involved in all development processes.
Research and publications
We critically review our treatment procedures and therapeutic measures in order to offer a modern and effective treatment concept. Research studies show us which measures are really necessary for an optimal result and which can be dispensed with. This enables us to reduce the treatment burden for the child and family to the necessary minimum. At the same time, we conduct laboratory research to develop promising new techniques and treatment alternatives and cooperate with various laboratories in Switzerland and abroad.
Here you will find current publications from our research group for cleft lip and palate and facial malformations.
Research and publications
Selection of some clinical articles in professional journals
- Benitez BK, Brudnicki A, Surowiec Z, Singh RK, Nalabothu P, Schumann D, Mueller AA. Continuous Circular Closure in Unilateral Cleft Lip and Plate Repair in One Surgery, Journal of Cranio-Maxillofacial Surgery, 2021, https://www.sciencedirect.com/science/article/pii/S1010518221001839.
- Benitez B, Brudnicki A, Nalabothu P, von Jackowski J, Bruder E, Mueller AA. Histologic aspect of the curved vomerine mucosa in cleft lip and palate. The Cleft Palate-Craniofacial Journal 2021; https://doi.org/10.1177/10556656211031419.
- Nalabothu P, Benitez BK, Dalstra M, Verna C, Mueller AA. Three-Dimensional Morphological Changes of the True Cleft under Passive Presurgical Orthopaedics in Unilateral Cleft Lip and Palate: A Retrospective Cohort Study. J Clin Med. 2020;9(4):962. doi.org/10.3390/jcm9040962.
- Mueller AA. Less surgery and more biology. Bulletin of the Association of Parents of Cleft Children. 31st issue, Feb. 2020.
https://lkg-spalte.ch/wp-content/uploads/id_spalte_2020_31.pdf. - Muller A, Brudnicki A, Surowiec. One-stage cleft repair with complete hard palatal wound closure by use of preoperative plate therapy and bipedicle palatal flaps. Conference Transactions. International Cleft Congress 2017, Chennai, India. 2017: 72-73.
- Indri I, Rovito L, Codoni S, Zeilhofer HF. New therapeutic approaches in the treatment of patients with cleft palate. Cranio Facial Kinetc Science (CFKSc) & Functional Kinetic Science (FKSc). Logos. 2016 ; 24 (4):265-271
- Mueller AA, Forraz N, Gueven S, Atzeni G, Degoul O, Pagnon-Minot A, Hartmann D, Martin I, Scherberich A, McGuckin C. Osteoblastic differentiation of Wharton jelly biopsy specimens and their mesenchymal stromal cells after serum-free culture. Plast Reconstr Surg. 2014 Jul;134(1):59e-69e
- Mueller AA, Kalak N, Schwenzer-Zimmerer K, Holsboer-Trachsler E, Brand S. Cortisol levels and sleep patterns in infants with OFC undergoing surgery. Neuropsychiatr Dis Treat, 2014 Oct 15;10:1965-72.
- Mueller AA, Schumann D, Reddy RR, Schwenzer-Zimmerer K, Mueller-Gerbl M, Zeilhofer HF, Sailer H, Reddy GS. intraoperative vascular anatomy, arterial blood flow velocity and microcircultion in uni- and bilateral cleft lip repair. plast and Reconstr Surg. 2012;130 (5):1120-30
- Mueller AA, Zschokke I, Brand S, Hockenjos C, Zeilhofer HF, Schwenzer-Zimmerer. one-stage cleft repair outcome at age 6- to 18 years - a comparison to the Eurocleft study data. Br J Oral Maxillofac Surg. 2011 Dec;49(8):e67-71.
- Schwenzer-Zimmerer K. Cleft lip and palate - only a surgical problem? Switzerland Med Forum 2011;11(46):824-829.
- Mueller AA, Paysan P, Schumacher R, Zeilhofer HF, Berg-Boerner BI, Maurer J, Vetter T, Schkommodau E, Juergens P, Schwenzer-Zimmerer K. Missing facial parts computed by a morphable model and transferred directly to a polyamide laser-sintered prosthesis: an innovation study. Br J Oral Maxillofac Surg. 2011;49(8):e67-71.
- Schwenzer-Zimmerer K, Boerner BI, Schwenzer NF, Mülller AA, Juergens P, Ringenbach A, Schkommodau E, Zeilhofer HF. Facial acquisition by dynamic optical tracked laser imaging: a new approach. J Plast Reconstr Aesthet Surg. 2009;62(9):1181-6.
- Brand S, Blechschmidt A, Mueller AA, Sader R, Schwenzer-Zimmerer K, Zeilhofer HF, Holsboer-Trachsler E. Psychosocial functioning and sleep patterns in children and adolescents with cleft lip and palate compared to healthy controls. Cleft Palate Craniofac J. 2009;46(2):124-35.
- Mueller AA, Sader R, Honigmann K, Zeilhofer HF, Schwenzer-Zimmerer K. Central nervous malformation in presence of clefts reflect their developmental interplay Int J Oral and Maxillofac Surg 2007; 36: 289-295
- Leiggener CS, Curtis R, Mueller AA, Pfluger D, Gogolewski S, Rahn BA. Influence of copolymer composition of polylactide implants on cranial bone regeneration. Biomaterials 2006; 27(2):202-7.
- Mueller AA, Rahn BA, Gogolewski S, Leiggener CS. Early dural reaction to polylactide in cranial defects of rabbits. Pediatr Neurosurg 2005; 41(6):285-91.
- Honigmann K. One-stage closure of uni- and bilateral cleft lip and palate . Br J Oral Maxillofac Surg 1996;34:214-9.
Books
- Masaracchia, R., Herzog-Isler, C., & Sader, R. A. Split feelings: Cleft lip, jaw and palate - a parent's guide. Zurich: Oesch; 2005.
- Honigmann, K. Cleft lip and palate: The Basel concept of a holistic approach. Bern: Verlag Hans Huber; 1998.
- Honigmann K. Centralized care of patients with cleft lip and palate. In: Oertli, D., & Laffer, U. Surgery from head to toe. Basel: Schwabe & Co; 1995.
Further links
Links self-help organizations
Appointments, patient coordination & nursing advice
We will be happy to advise you individually and answer your questions personally. Please make an appointment(+41 61 328 73 47, Mon/Thu) or call us directly for information(+41 61 328 60 95).
Anita Lukic
Special Nurse
Resource Nursing Specialist Development
Appointments Monday and Thursday under:
+41 61 328 73 47
Email daily at:
anita.lukic@usb.ch
For administrative matters
Hümeyra Yagci
Secretary Prof. Dr. med. Dr. med. dent. Müller
Phone +41 61 556 55 49
huemeyra.yagci@usb.ch
Facial malformations
Multidisciplinary treatment is also a priority for other rare facial malformations. At the university center, children with Pierre Robin sequence are offered a special plate (Tübingen plate or Preepiglotic-Baton plate) in the first few days after birth. This helps to treat airway obstruction and enable feeding as well as promoting the growth of the receding lower jaw. In the case of facial malformations such as Treacher-Collins syndrome (Franceschetti syndrome, mandibulofacial dysostosis) or hemifacial microsomia (Golden Hair syndrome), we coordinate individual treatment planning across a wide range of specialist disciplines.
Rare congenital facial tumors such as vascular malformations are discussed at interdisciplinary conferences and treated with the respective specialists.
Appointments, patient coordination & nursing advice
We will be happy to advise you individually and answer your questions personally. Please make an appointment(+41 61 328 73 47, Mon/Thu) or call us directly for information(+41 61 328 60 95).
Anita Lukic
Special Nurse
Resource Nursing Specialist Development
Appointments Monday and Thursday under:
+41 61 328 73 47
Email daily at:
anita.lukic@usb.ch
For administrative matters
Hümeyra Yagci
Secretary Prof. Dr. med. Dr. med. dent. Müller
Phone +41 61 556 55 49
huemeyra.yagci@usb.ch
Cranial deformities
We have been offering a special consultation for children with positional head deformities for several years. Here we assess children with head deformities and advise parents on treatment with a head prosthesis (helmet therapy). After a medical examination and a three-dimensional photograph of the head, we can provide parents with detailed advice in an information session.
With a custom-made head prosthesis, the child's growth can be guided in such a way that the head deformity and any facial asymmetries are corrected. The presentation can take place at any time after birth, with treatment ideally starting at the age of 4 months, as the duration of treatment depends on the age of the child and the extent of the head deformity.
In the case of head deformities that are not position-related but are caused by premature ossification of the cranial sutures (craniosynostosis), we work together with neurosurgery. Here too, modern treatment methods following endoscopic surgery (keyhole surgery) may indicate follow-up treatment with a head prosthesis in our special consultation hours.
Dates
We will be happy to advise you individually and answer your questions personally.
Please make an appointment.
Registration for oral and maxillofacial surgery
Appointments for head deformities
Phone +41 61 265 70 70