Letters
Specialised multidisciplinary team can solve problems of distance
EDITOR,--We believe the editorial on managing cleft lip and palate to be misleading.1 The Eurocleft study indicated that the outcome of repair of cleft lip and palate was inversely proportional to the number of operators.2 To suggest that cleft surgery services should be devolved to local hospitals with multiple operators undertaking few procedures therefore seems illogical and is also at odds with the situation in continental Europe, where cleft surgery is concentrated into a small number of centres.
Anatomical specialisation seems logical, but the suggestion that high volume operators in adult maxillofacial surgery are the best qualified to undertake primary cleft surgery in infants denies the differences in the nature of the tissues (which change appreciably with age), the surgery itself, and the management of children compared with that of adults. In Britain most primary cleft surgery is undertaken by plastic surgeons working as part of multidisciplinary teams. Maxillofacial surgeons
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- Managing cleft lip and palate
- Tony Markus and Peter Ward Booth
BMJ 1995 311: 765.[Extract] [Full Text]
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