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Cleft Lip and Palate Program

The Cleft Lip and Palate Program at Arkansas Children's Hospital incorporates a comprehensive multidisciplinary team, with each member specialized in pediatric care. An important advantage of the team approach is that the team's professionals are in direct and continuous communication about the child's care. The goal of the team is to ensure that care is provided in a coordinated, consistent manner with the proper sequencing of evaluations and treatments within the framework of the child's overall developmental, medical and psychological needs.

Each team member is fully aware of the child's specific needs and progress and is able to make recommendations for care which are consistent with those given by other team members. The Cleft Lip and Palate Team at ACH is fully accredited by the American Cleft Palate Association (ACPA) and is one of many programs at ACH which provide high quality, individual service to children with special health care needs. Since 1978, almost all children born in Arkansas with cleft lip/palate have been treated at ACH. The team was started by world-renowned pediatric otolaryngologist Dr. Robert Siebert who passed down his knowledge to Dr. Larry D. Hartzell.

ENT surgeons, Dr. Hartzell and Dr. Adam Johnson not only perform the primary cleft repair and bone grafting but provide comprehensive expertise in otologic and airway issues that may arise.  Dr. Johnson also directs the Velopharyngeal Insufficiency Clinic ( VPI) dedicated to both cleft and non-cleft patients experiencing speech disorders. 

Plastic Surgeon, Dr. Sagar Mehta is the director of the Craniofacial Team at ACH and specializes in primary cleft lip and palate surgery, alveolar bone grafting, orthognathic (jaw) surgeries, and cleft rhinoplasty.

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Possible Conditions

Possible Treatments

Our Cleft Lip & Palate team has extensive experience treating all types of clefts and related disorders.

 

Nasoalveolar Molding (NAM)

NAM was originally developed by an ENT & Plastic Surgeon, Dr. Court Cutting, and craniofacial orthodontist, Dr. Barry Grayson at New York University (NYU) and is now available with all surgeons at Arkansas Children's. Not all babies with clefts are candidates for NAM, but for those that are, the retainer-like device can greatly help to narrow the width of the cleft, the gums and improve nasal shape.

Health at Home

Web Resources

We know the concern families must experience when a newborn is born with a cleft lip and palate condition. However, learning all you can about these conditions can help you understand your child's situation and enable you to ask your doctor about any new developments in treatment. The following links provide the latest information on these important topics:

Camp Laughter Supports Patients

The cleft and craniofacial teams at Arkansas Children's Hospital collaborate with Camp Aldersgate to provide a one-day camp for children living with cleft and craniofacial differences and their family members. Camp Laughter is a free annual event that occurs the 1st Saturday in August. This all-day event is for kids ages 5-18, who are in school and have a cleft or craniofacial difference.   They can participate in various outdoor activities while connecting with other children just like them.

Arkansas Children’s Cleft Team Provides Humanitarian Work in Ecuador

Two UAMS/Arkansas Children’s Hospital (ACH) cleft palate team members are playing an active role in humanitarian work in Guayaquil, Ecuador, with the nonprofit organization Global Smile Foundation (GSF).

Adam Johnson, M.D., Ph.D. - Otolaryngologist, Cleft Surgeon and ACH Velopharyngeal Insufficiency (VPI) Clinic Director – and Lucia Wesley, R.N., Otolaryngology Specialty Nurse and Cleft Team Coordinator, have participated in three missions over three years and have made ongoing commitments to the organization. Read more about their missions.

Meet the Team

The Pediatric Otolaryngologist/Plastic Surgeon - These specialists are responsible for the surgical closure of the cleft and related operations which your child may require. Any ear disease, speech disorder or hearing loss, will also be closely monitored and treated by these physicians. 

The Audiologist - Since children with cleft palate have an increased risk of ear problems, ongoing audiological surveillance is necessary. The audiologist provides appropriate assessments for monitoring hearing status so that diagnosis and treatment can be made for any cleft-related hearing problems. 

The Dental Specialists - The dental specialists include the pediatric dentist, orthodontist, oral surgeon, periodontist, and prosthodontist. These specialists keep track of your child's dental growth and development and provide information on oral hygiene and dental treatment that may be necessary due to the cleft. 

The Geneticist - The geneticist alongside his genetic counselor, is available to discuss how clefts of the lip and palate occur and to answer questions about the risk of recurrence with future pregnancies. Later, this specialist can help your teenager understand the cause of a cleft and advise him or her about individual circumstances.

The Neuropsychologist - The neuropsychologist is available to discuss you or your child's concerns.
 
The Speech Pathologist - The speech pathologist will provide you with information about typical speech development along with suggestions for stimulation speech when your child is very young. Speech and swallowing dysfunction will be closely monitored and appropriate treatments or therapies will be prescribed at Arkansas Children's or if appropriate, closer to home. 

The Social Worker - The clinical social worker is available to meet with the family to assist in the psychosocial and emotional aspects of cleft lip/palate. This specialist is aware of services available in the community to which the family can be referred for information on medical coverage, financial assistance, and support groups/services. 

The Clinical Nutritionist - The nutritionist assists with any early feeding difficulties and monitors the child¹s nutritional intake. This specialist also provides follow-up of weight gain and height/weight parameters and provides information and support with specific diets related to some of the surgeries. 

The Registered Nurse - The nurse is available as a contact person to provide information and ensure that parents understand their child's health needs, treatment plan and follow-up. This specialist assists with the child's presurgical readiness and post-surgical recovery and provides instructions for home care.

Locations

Make an Appointment

Children may be referred for evaluation and treatment at the cleft clinic by physicians, speech therapists, teachers, families, guardians or others concerned with their general growth and development. 

To make an appointment at the cleft clinic, please contact Jo McCallie, cleft team administrative assistant, at 501-364-7546, or Sarah Valdez, cleft team coordinator, at 501-364-2184. Dr. Larry D. Hartzell, director of the cleft lip & palate program, also may be reached via e-mail at cleftteam@archildrens.org.

  • The Cleft Multidisciplinary Team Clinic meets the first Wednesday of each month.
  • Regular, New and Follow-Up Cleft Clinics meet weekly and vary per surgeon.

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