Skip to main content

Cleft and Craniofacial Learning Resources

Here you will find links to educational resources for different aspects of cleft and craniofacial care. Thanks to Yul Kahn-Pascual for his help with amalgamating these resources. This project is in its infancy so please do contact the web team with your feedback and ideas for how to expand going forward.

Core Knowledge





Process and timing of craniofacial development

Facial development: Embryology Video


Facial region Embryology + Development

Part 1


Part 2


Part 3


Development of the upper lip: morphogenetic and molecular mechanisms.

Jiang et al.


Palatogenesis: morphogenetic and molecular mechanisms of secondary palate development.

Bush and Jiang 2012


Growth and development

Principles of paediatric physiology and craniofacial growth mechanisms

Growth sites and growth mechanisms at risk in cleft lip and palate.

Hans Friede 1998


The impact of cleft lip and palate repair on maxillofacial growth.

Shi and Losee 2015


Bone biology

Principles of bone healing, bone grafts and distraction osteogenesis

Bone biology + Physiology

Buck and Dumanian 2012

Part 1


Part 2


Distraction Osteogenesis Part 1: History and Uses in the Craniofacial Region.

Barber et al 2018.


Speech development

Mechanisms of speech and relation to feeding, swallowing and hearing.

Book – Case studies in Cleft Palate Speech by Anne Harding-Bell (Covers early speech development, cleft speech errors and appropriate speech management and includes video clips and recording to enable transcribing practice


Book – Cleft Palate Speech: Assessment and Intervention by Sara Howard and Anette Lohmander


Book - Speech Therapy in Cleft Palate and Velopharyngeal Dysfunction by Ginette Phippen and The Spires Cleft Centre SLT Team


Issues in perceptual speech analysis in cleft palate and related disorders: a review

Sell 2005


Characteristics of cleft palate speech

Harding and Grunwell


Speech evaluation for patients with cleft palate

Kummer 2014

Pre-operative workup

Range of normal pre-operative paediatric parameters, risk factors for anaesthetic and operation

Anaesthesia for cleft lip and palate surgery

Sommerville and Fenlon 2005


GAS 1 Trial

Davidson et al 2016


GAS 2 Trial

McCann et al 2019


Cleft related syndromes




22q11.2 Deletion

Pathophysiology, classification, recognition and management options/priorities

Chromosome 22q11.2 Deletion Syndrome

McDonald-McGinn and Sullivan 2011


Velocardiofacial syndrome, DiGeorge syndrome: the chromosome 22q11.2 deletion syndromes

Kobrynski and Sullivan 2007


Surgical management of Velopharyngeal Incompetence in Velocardiofacial Syndrome

Mehendale et al., 2004


Pierre Robin Sequence

Pathophysiology, recognition and management options/priorities

Pierre Robin Sequence: A comprehensive narrative review of the literature over time.

Giudice et al., 2018


A new grading of Pierre Robin Sequence

Cole et al., 2008


Best Practices for the Diagnosis and Evaluation of Infants With Robin Sequence: A Clinical Consensus Report. Breugem et al. 2016


Treacher Collins

Pathophysiology, recognition of phenotype and management options/priorities

Treacher Collins Syndrome: etiology, pathogenesis and prevention

Trainor et al., 2008


The Surgical Management of Treacher Collins Syndrome.

Cobb et al., 2014


Pathophysiology, recognition of phenotype and management options/priorities

Therapeutic and diagnostic advances in Stickler Syndrome

Snead et al., 2020


Stickler syndrome – lessons from a national cohort

Snead et al., 2021

Van der Woude

Pathophysiology, recognition of phenotype and management options/priorities

Van der Woude syndrome: a review

Rizos and Spyropoulos 2004


Loeys Deitz

Pathophysiology, recognition of phenotype and management options/priorities

Loeys-dietz: a primer for diagnosis and management

MacCarrick et al., 2014






Antenatal diagnosis

Possibilities and limitations of antenatal diagnosis, likelihood of undiagnosed coexistent abnormalities

30 years of Prenatal Cleft Diagnosis: What have we learned?

Steinberg and Gosain, 2015


Breaking the News: Parents’ experiences of receiving an antenatal diagnosis of cleft lip

Stock et al., 2019


Pre-surgical orthopaedics




Pre-surgical orthopaedics

Principles, indications and awareness of advantages and disadvantages

Systematic review of the long-term effects of presurgical orthopedic devices on patient outcomes

Garland et al., 2021


Presurgical Nasoalveolar Molding in infants with cleft lip and palate

Grayson et al., 1999



Early Cleft Surgery in Infancy




Overview of early cleft surgery

Surgical anatomy, pathological anatomy, rationale of techniques, timing and sequence

Cleft lip, cleft palate and velopharyngeal insufficiency

Fisher and Sommerlad 2011


Range and timing of surgery, and surgery sequences used, in primary repair of complete unilateral cleft lip and palate: The Cleft Care UK study

Slator et al., 2020


A closer look at delayed primary cleft surgery and unrepaired cleft lip and/or palate in 5 UK cleft centers

Butterworth et al., 2021


Current surgical practice for children born with a cleft lip and/or palate in the United Kingdom

Fell et al., 2022


PRS Cleft Video Collection


Unilateral cleft lip reconstruction

Surgical anatomy, pathological anatomy, rationale of techniques, timing and sequence

The Millard Rotation-Advancement Cleft Lip Repair: 50 years of Modification

Roussel et al., 2015


Unilateral cleft lip repair: an anatomical subunit approximation technique

Fisher 2005


Unilateral cleft lip repair using the anatomical subunit approximation

Tse and Lien 2014


Long-term comparison of four techniques for obtaining nasal symmetry in unilateral complete cleft lip patients: A single surgeon’s experience

Chang et al., 2010


The essential anatomical subunit approximation unilateral cleft lip repair

Chong and Swanson 2016


Unilateral cleft lip nasal deformity: Foundation-based approach to primary rhinoplasty

Tse et al., 2019

Bilateral cleft lip reconstruction

Surgical anatomy, pathological anatomy, rationale of techniques, timing and sequence

Repair of bilateral complete cleft lip and nasal deformity – state of the art

Mulliken 2000


Modern tenets for repair of bilateral cleft lip

Allori and Marcus 2014


A guide to bilateral cleft lip markings: an anthropometric study of the normal cupid’s bow

Loo et al., 2021

Primary cleft palate reconstruction

Surgical anatomy, pathological anatomy, rationale of techniques, timing and sequence

A technique for cleft palate repair

Sommerlad 2003


The use of the operating microscope for cleft palate repair and pharyngoplasty

Sommerlad 2003


Cleft palate repair by double opposing Z-plasty

Furlow 1986


Cleft palate repair: description of an approach, its evolution, and analysis of postoperative fistulas.

Tse and Siebold 2017


Maxillary growth in cleft lip and palate patients, with and without vomerine flap closure of the hard palate at the time of lip repair

Hay et al., 2018


Surgical variation between consultant surgeons performing a Sommerlad radial intravelar veloplasty

Butterworth et al., 2021

Submucous cleft palate

Surgical anatomy, pathological anatomy, rationale of techniques, timing and sequence

Submucous cleft palate: A grading system and review of 40 consecutive submucous cleft palate repairs

Sommerlad et al., 2004


Later Cleft Surgery in Childhood and Adolescence




Palatal fistulae

Assessment of palatal fistulae and awareness of reconstructive options

Fistula incidence after primary cleft palate repair: a systematic review of the literature

Hardwick et al., 2014


Closer to the truth on national fistula prevalence after unilateral complete cleft lip and palate repair? The Cleft Care UK Study

Yang et al., 2020


A successful algorithm for limiting postoperative fistulae following palatal procedures in the patient with orofacial clefting

Losee et al., 2008


Pakistan comprehensive fistula classification: a novel scheme and algorithm for management of palatal fistula/dehiscence.

Fayyaz et al., 2019




Velopharyngeal function and surgical intervention for VPI

Anatomy and physiology of palatal function and pathophysiology of VPI

The evaluation and management of velopharyngeal dysfunction

Marsh 2004


Surgery for velopharyngeal dysfunction: a systematic review of interventions and outcomes.

De Blacam et al., 2017


Posterior pharyngeal flap and sphincter pharyngoplasty: the state of the art

Sloan 2000


The buccinator mucomuscular flap: an in-depth analysis and evaluation of its role in the management of velopharyngeal dysfunction

Ahl et al., 2016

Alveolar bone graft

Evolution of secondary dentition, orthodontic investigation and treatment

An evaluation of alveolar bone grafting in the UK and Ireland

Jauhar et al., 2018


Alveolar bone grafting and cleft lip and palate: a review

Weissler et al., 2016

Cleft Septo-Rhinoplasty

Pathological anatomy of cleft nose and reconstructive options of approach and technique

Rhinoplasty for cleft nose deformity

Holmes 2019


Evidence-based medicine: Secondary correction of cleft lip nasal deformity

Allori and Mulliken 2017

Cleft related orthognathic surgery

Anatomy and pathological anatomy of facial growth, planning and orthognathic principles and appliances

Outcomes of maxillary orthognathic surgery in patients with cleft lip and palate: A literature review

Ganoo et al., 2019








Single Suture

Surgical anatomy, pathological anatomy and pathophysiology

Update in the management of craniosynostosis 

Xue et al 2022


A review of the management of single-suture craniosynostosis, past, present and future

Proctor and Meara 2019


Craniosynostosis – Recognition, clinical characteristics and treatment

Kajdic et al., 2018



AO Foundation – Craniosynostosis



Spring-assisted cranioplasty for the correction of nonsyndromic scaphocephaly: A quantitative analysis of 100 consecutive cases

Rodgers et al., 2017


VIDEO: Spring-mediated cranioplasty for sagittal craniosynostosis

Kalmar and Swanson 2021



Modification of the Melbour7ne method for total calvarial vault remodeling

Hughes et al., 2018



Genetics of syndromes, recognition of phenotypes, indications for intervention, strategies for intercranial hypertension

Syndromic craniosynostosis

Sawh-Martinez and Steinbacher 2019


Syndromic craniosynostosis: Unique management considerations

Hersh and Hughes 2022


Syndromic craniosynostosis: complexities of clinical care

O’Hara et al., 2019








Applied anatomy of the orbits, definition of terms and differential diagnosis. Awareness of box osteotomies and facial bipartition.


State-of-the-art hypertelorism management

Shakir et al., 2019



AO Foundation: Box Osteotomies


AO Foundation: Facial Bipartition


Monobloc distraction and facial bipartition distraction with external devices

Dunaway et al., 2021


Craniofacial deficiency




Craniofacial microsomia

Pathophysiology, classification, recognition and management options/priorities

The O.M.E.N.S. classification of hemifacial microsomia

Vento et al., 1991


Surgical correction of craniofacial microsomia: evaluation of interventions in 565 patients in three major craniofacial units

Britt et al., 2019


Surgical correction of the midface in craniofacial microsomia. Part 1: a systematic review

Van de Lande et al., 2018!


European Guideline Craniofacial Microsomia

Renkema and the ERN CRANIO Working Group 2020

Ear reconstruction

Applied anatomy of ear, principles of osseointegration, locoregional flap options, principles of tissue expansion

Microtia Part 1: Anatomy/Embryology

Beahm and Walton, 2002


Microtia Part 2: Surgical Techniques

Walton and Beahm, 2002


Microtia reconstruction

Wilkes et al., 2014

Craniofacial clefts

Pathophysiology, classification and management principles

Anatomical classification of facial, craniofacial and latero-facial clefts

Tessier 1976


Rare Facial Clefts

Reddy and Acharya 2021







Outcome assessment

Methods to assess outcomes in cleft and craniofacial

A review of outcome measures used in cleft care. Jones et al., 2014


Measuring outcomes in CL/P treatment. Sitzman et al 2014.


What matters to patients with cleft lip and/or palate: An international qualitative study informing the development of the CLEFT-Q

Wong et al., 2017


Facilitators and Barriers to Implementing Standardized Outcome Measurement for Children With Cleft Lip and Palate.

Weidler et al. 2021


A Standard Set of Outcome Measures for the Comprehensive Appraisal of Cleft Care.

Allori et al. 2017