Cleft Lips and Palates

[KitesurfDaEarth]

Does anyone know of any programs where the Otolaryngology Service run the cleft lip and palate reconstruction. I am interested in oto and extremely interested in a program that will provide this sort of training. I know Tufts has a program, does anyone know of anywhere else? Thanks

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[resxn]

I trained at Colorado and Dr. Greg Allen runs the cleft lip/palate clinic in The Children's Hospital there. Residents can graduate with enough cases to feel comfortable with most repair techniques to do them in private practice without having had a fellowship. If you're aggressive you could probably do 20-30 palates and 10-20 lips in that program during your 8 months total you'll spend on rotations there during residency.

I think there's a guy who does that many or more in MN as an ENT, but I'm not sure much more than that.

 

[chirurgino]

There aren't very many ENT programs that handle cleft lip/palate--usually it's plastic surgery (this never made sense to me). Iowa is one program that does cleft lip/palate, and they get good volume. In general, my impression of Iowa was that you get a lot of experience in ENT that would be handled by plastics at a place with a stronger plastics program (or a weaker ENT program...ENT is king at Iowa).

That being said, if you're serious about doing pediatric craniofacial, you may have to do a 3-year plastics fellowship after ENT (one of the chiefs this year at Iowa will be starting a plastics fellowship next year for this reason).

 

[TheThroat]

Iowa is one program that does cleft lip/palate, and they get good volume. In general, my impression of Iowa was that you get a lot of experience in ENT that would be handled by plastics at a place with a stronger plastics program (or a weaker ENT program...ENT is king at Iowa).

That being said, if you're serious about doing pediatric craniofacial, you may have to do a 3-year plastics fellowship after ENT (one of the chiefs this year at Iowa will be starting a plastics fellowship next year for this reason).

I agree with all of this. Iowa has almost no plastics program and John Canady does almost all the cleft surgeries in Iowa.

My thoughts on doing clefts directly after oto residency is that you can have the experience and the know how, but if you are in private practive, then you also have to convince your fellow ENT's and pediatricians that you are the man, instead of a plastic surgeon. If you are in academics, you'll have to have the additional fellowship training.

I would be very surprised to see a non-fellowship trained private practice ENT doing a lot cleft surgery.

 

[resxn]

I agree with all of this. Iowa has almost no plastics program and John Canady does almost all the cleft surgeries in Iowa.

My thoughts on doing clefts directly after oto residency is that you can have the experience and the know how, but if you are in private practive, then you also have to convince your fellow ENT's and pediatricians that you are the man, instead of a plastic surgeon. If you are in academics, you'll have to have the additional fellowship training.

I would be very surprised to see a non-fellowship trained private practice ENT doing a lot cleft surgery.

That's true, most of the private practice guys that do clefts are plastics not ENT, but I think that is a reflection of the history of the training which plastics has and continues to dominate. There is a private practice ENT who is not fellowship trained in UT who does quite a few clefts, but he worked for years to get on the cleft team at the Children's hospital there. It's not an easy road, but possible.