Carter and Mason Osborne have a lot in common. Not only are they brothers who love to laugh, they also share one unique characteristic; they were born with forms of cleft lip and palate. Fortunately, the Osborne's have a team of nationally-recognized experts in the Cleft Lip and Palate Center at Nationwide Children's Hospital to help with their sons' overall treatment and care. While the odds of having a child born with cleft lip and palate are 1 in 700, the odds increase significantly for parents who already have a child with cleft lip and palate.

Cleft lip and palate, a condition often believed to occur more frequently in developing countries, is the most common birth defect in the United States after congenital heart disease. Genetics plays an important role in the development of cleft lip and palate, as seen in the Osborne brothers, but environmental factors such as prenatal exposure to alcohol, cigarettes, illicit drugs, and some medications may play a role in some cases.

"The first time we even thought about a cleft lip was just moments after our oldest son, Carter was born," said Chelsee Osborne, mother of Carter and Mason. "Then, it happened again. The look on the nurse's face, I could tell something was wrong - not in a million years did we think this could happen again."

The Cleft Lip and Palate Center at Nationwide Children's offers children and their families' comprehensive care from a multi-disciplinary team of nationally recognized clinicians. Led by Richard Kirschner, MD FACS, FAAP, chief of Plastic Surgery, the team comprises experts from numerous specialties including genetics. The geneticist evaluates every new patient to determine if the cleft is isolated or part of an underlying syndrome.

In addition to the geneticist, the team is also composed of experts from plastic surgery, oral and maxillofacial surgery, orthodontics, otolaryngology (ENT), audiology, speech-language pathology, nursing, dentistry, social work and psychology. This team of medical professionals helps optimize facial appearance, speech, hearing, dentofacial development and overall self-concept for children with cleft lip and palate.

"Surgery is only the beginning," said Dr. Kirschner, also professor of Clinical Surgery and Pediatrics at The Ohio State University College of Medicine. "No longer are we simply taking care of children as surgeons alone, but as surgeons as part of a multi-disciplinary health care team to address all of the areas of function and psycho-social well-being."

Due to the advances in technology, cleft lip and palate can now be diagnosed during a prenatal visit. By using a level two ultrasound, obstetricians can identify the condition in-utero. To help families understand the extent of their child's condition, the Cleft Lip and Palate Center at Nationwide Children's also offers educational programs and outreach to educate families of the care and treatment needed for children diagnosed with cleft lip or palate.

In addition to advances in technology, surgical techniques have evolved which has improved the outcomes of children born with cleft lip or palate dramatically. "Our team of experts not only work to improve the physical appearance of these children, they also work to give them a normal smile, normal speech and ultimately, a normal life," said. Dr. Kirschner.

Nationwide Children's Hospital