Research and publications from the Cleft Lip and Palate Team

The cleft team has a long history of clinical research and audit activity.  It is a multi-disciplinary service and the contributions have been from speech and language therapists, psychologists, audiological physicians, orthodontists, paediatricians, as well as surgeons.


The team has also supervised higher degrees (MSc and PhD) and continues to do so. Team members have established systems for measurement of outcomes of speech and facial bone growth in cleft patients and have also contributed to cleft research overseas.

Current interests include:

Patient’s perspective

A project is underway at the moment, led by Lizzy McDowell in clinical psychology and her colleagues, examining the patient experience of inpatient treatment for adolescents and young people.

Surgical technique

The team regularly publishes outcomes of new techniques. A recently completed study, by Greet Hens and co-workers, looked at the outcome of an operation using cheek tissue to lengthen the palate for those children whose palates are too short. The paper on this technique, known as buccinator flaps, is submitted.

The service is also looking at new methods of monitoring surgical outcomes, currently published on our clinical outcomes page, showing the cumulative sum graph of outcomes for patients with isolated cleft palate.

A detailed analysis of this data looking at the risk factors leading to poorer outcome is being studied as a paper led by Duncan Atherton and co-workers.

Children with cleft may require surgery on their facial bones known as an osteotomy. However, this may cause their speech to deteriorate. Valerie Pereira and co-workers are looking at the factors leading to poorer outcome in patients undergoing osteotomy. This work is also part of a PhD.

We also have a basic science study looking at reasons why some children have poor palate movement causing poor speech. The study is looking at palate anatomy, anatomy and physiology and genetics. Leila Rees is the principal worker.

Growth charts for Sri Lanka

Our growth charts were conducted jointly with the University of Ruhuna, Southern Sri Lanka, under the banner of GOSH cleft services, as part of the Sri Lanka Cleft Lip and Palate Project. They comprise height, weight, body mass index and head circumference seven centile charts designed for use by professionals who wish to compare individuals with the local peer group, not only with an optimally grown International reference population. Two age spans are available, birth to five years and birth to 25 years.

Girls growth in Sri Lanka

22q11 deletion syndrome growth charts (213.3 KB)

We also have , which provide more information about the condition.

For more information visit the Max Appeal charity website.


Reference 1

Demircioglu M, Kangesu L, Ismail A, Lake E, Hughes J, Wright S, Sommerlad BC (2008) Increasing accuracy of antenatal ultrasound diagnosis of cleft lip with or without cleft palate, in cases referred to the North Thames London Region. Ultrasound Obstet Gynecol 31 (6): 647-51

Reference 2

Lees M (2008) Familial risks of oral clefts. BMJ 336 (7641): 399

Reference 3

Sinko K, Caacbay E, Jagsch R, Turhani D, Baumann A, Mars M (2008) The GOSLON yardstick in patients with unilateral cleft lip and palate: review of a Vienna sample. Cleft Palate Craniofac J 45 (1): 87-92

Reference 4

Kantaputra PN, Paramee M, Kaewkhampa A, Hoshino A, Lees M, McEntagart M, Masrour N, Moore GE, Pauws E, Stanier P (2011) Cleft lip with cleft palate, ankyloglossia, and hypodontia are associated with TBX22 mutations. J Dent Res 90 (4): 450-5

Reference 5

Reference 6

Andreou AM, Pauws E, Jones MC, Singh MK, Bussen M, Doudney K, Moore GE, Kispert A, Brosens JJ, Stanier P (2007) TBX22 missense mutations found in patients with X-linked cleft palate affect DNA binding, sumoylation, and transcriptional repression. Am J Hum Genet 81 (4): 700-12

Reference 7

Reference 8

Chorbachi R, Graham JM, Ford J, Raine CH (2002) Cochlear implantation in Jervell and Lange-Nielsen syndrome. Int J Pediatr Otorhinolaryngol 66 (3): 213-21

Reference 9

Kravariti E, Jacobson C, Morris R, Frangou S, Murray RM, Tsakanikos E, Habel A, Shearer J (2010) Memory in intellectually matched groups of young participants with 22q11.2 deletion syndrome and those with schizophrenia. Res Dev Disabil 31 (3): 864-8

Reference 10

Pereira V, Sell D, Ponniah A, Evans R, Dunaway D (2008) Midface osteotomy versus distraction: the effect on speech, nasality, and velopharyngeal function in craniofacial dysostosis. Cleft Palate Craniofac J 45 (4): 353-63

Reference 11

Henningsson G, Kuehn DP, Sell D, Sweeney T, Trost-Cardamone JE, Whitehill TL, Speech Parameters Group (2008) Universal parameters for reporting speech outcomes in individuals with cleft palate. Cleft Palate Craniofac J 45 (1): 1-17

Reference 12

Reference 13

Sell D, Mars M, Worrell E (2006) Process and outcome study of multidisciplinary prosthetic treatment for velopharyngeal dysfunction. Int J Lang Commun Disord 41 (5): 495-511

Reference 14

Sinko K, Caacbay E, Jagsch R, Turhani D, Baumann A, Mars M (2008) The GOSLON yardstick in patients with unilateral cleft lip and palate: review of a Vienna sample. Cleft Palate Craniofac J 45 (1): 87-92

Reference 15

Masarei AG, Sell D, Habel A, Mars M, Sommerlad BC, Wade A (2007) The nature of feeding in infants with unrepaired cleft lip and/or palate compared with healthy noncleft infants. Cleft Palate Craniofac J 44 (3): 321-8

Reference 16

Liao YF, Cole TJ, Mars M (2006) Hard palate repair timing and facial growth in unilateral cleft lip and palate: a longitudinal study. Cleft Palate Craniofac J 43 (5): 547-56

Reference 17

Lilja J, Mars M, Elander A, Enocson L, Hagberg C, Worrell E, Batra P, Friede H (2006) Analysis of dental arch relationships in Swedish unilateral cleft lip and palate subjects: 20-year longitudinal consecutive series treated with delayed hard palate closure. Cleft Palate Craniofac J 43 (5): 606-11

Reference 18

Liao YF, Mars M (2006) Hard palate repair timing and facial growth in cleft lip and palate: a systematic review. Cleft Palate Craniofac J 43 (5): 563-70

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Reference 20

Batra P, Tejani Z, Mars M (2006) X-linked hypophosphatemia: dental and histologic findings. J Can Dent Assoc 72 (1): 69-72

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