S.   Berkowitz (Ed)
 

The second edition of Cleft Lip and Palate: Diagnosis and Management is an unparalleled review of treatment concepts in all areas of cleft involvement presented by an international  team of experienced clinicians. This text can never be duplicated since it largely consists of longitudinal facial and palatal growth studies of dental casts, photographs panorexes and  cephalographs  from birth to adolescence. Throughout all growth and treatment concepts, the need for differential diagnosis in treatment planning has been underscored. The underlying argument is that all of the treatment goals , good speech, facial aesthetics and dental occlusion , may be realized without the need to sacrifice one for the other. Every chapter author's concepts arose from extensive experience subjected to testing. Emphasis is placed on the essential character of multicenter clinical studies for improving understanding of the natural history of the cleft and the face in which it is found.

From the contents:
> Facial embryology and neonatal palatal cleft morphology
> Types of Clefts. Facial growth in cleft palate children
> Lip and palate surgery
> Presurgical orthopedics
> Mid-facial changes
> Orthognatic surgery

> The nasopharygeal area
> Speech
>The future


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2005. 2nd ed.  Approx. 700 p. 500 illus., Hardcover
ISBN 3-540-23409-8 > ca. $ 460.00


 

Fortunately since the 1950’s many clinical investigators in the field of the cleft palate have performed excellent clinical studies of the management of the cleft lip and palate that have contributed to the intellectual ferment over the last 50 years. To these studies we are indebted, since to know this literature is vital for correct treatment planning.

When selecting significant references for this text, every attempt was made to carry out an exhaustive literature search to include all of the excellent articles on each subject covered.

To familiarize clinicians with the appropriate literature and its importance  to the treatment of cleft lip and cleft palate, the chapters in this book are structured to improve clinicians’ understanding of the natural history of the cleft  defect, the face in which it exists, the influence of surgery on palatal growth and development, and equally importantly in developing an appreciation for heterogeneity that exists even within a single cleft type.

These chapters will show that chronological age is not the parameter that really matters in determining the age at which to close the cleft in the palate. What is important is morphologic age and physiological fitness, that is, whether the tissues are adequate in quantity and whether the geometric relationship of cleft parts is favorable or unfavorable for reconstruction. Some question incidents to growth, which date back 25 years, concern the relationship of the malformed palatal segments to the contiguous skeletal anatomy, which, in turn, may be anomalous. These following questions are also addressed: Are the palatal segments static in their deficiency or does the deficiency diminish in time, that is, is “catch up growth” a predictable phenomenon? And if so, what surgical procedures (as to age and type) make it possible?

Many of Pruzansky’s thoughts , written so many years ago, still hold true today and are worth repeating. He stated that whoever sees things from their beginning will have the most advantageous view of them. To that end, most of the serial cases presented in this volume start soon after birth when plaster casts and photographs of the palatal and facial defects are taken. Serial lateral cephaloradiographs are added as soon as the chilld is manageable, and again taken periodically through adolescence.

It is hoped that clinicians who are just beginning their involvement in cleft palate will learn the pathology and its natural history of cleft palate from the cases presented in this book and appreciate the need to keep careful records (casts, cephaloradiographs, photographs, and panorexes) which are of vital important to both the processing of knowledge and self criticism.

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