Contact the Cleft and Craniofacial Center
If you have questions or would like to set up an appointment, please call the Cleft and Craniofacial Center.
Your Child Cared for by Nationally Recognized Doctors
The Cleft and Craniofacial Center at Rhode Island Hospital and its Hasbro Children’s Hospital is one of the oldest in New England. It was started over 50 years ago by Dr. Armand Versace, who also developed the plastic surgery residency program in 1963. Beginning with a strong foundation in multispecialty care, trusted colleagues were enlisted to manage children and adults with complex craniofacial anomalies. The team eventually moved to Hasbro Children’s Hospital in 1994 and the program continues to flourish. The Cleft and Craniofacial Team has been accredited by the American Cleft Palate-Craniofacial Association since the inception of this certification process in 2009.
Our program has treated thousands of children and adults with cleft lip, cleft palate, craniosynostosis and other craniofacial anomalies. We know that being the parent of a child with a craniofacial condition can feel confusing and overwhelming. Our team is committed to providing education and support to both children and their families. We also welcome all those who may have received treatment at other hospitals and are seeking continued care. We personalize the treatment plan for each individual and are committed to finding the best possible outcome for every patient.
Our multidisciplinary team of professionals provides the full spectrum of care, from prenatal consultation to complex care management for children and adults. Our team meets regularly to evaluate patients in a multidisciplinary clinic setting that is more convenient for patients and families and promotes open, easy communication among medical providers.
- Plastic and reconstructive surgery
- Otolaryngology (ear, nose and throat surgery)
- Oral and maxillofacial surgery
- Speech-language pathology
- Feeding specialist
- Family resource specialist
Personalized Medical Care
Each person with a craniofacial condition is unique. Therefore, the treatment plan is customized for every individual. We provide treatment plans for your child’s diagnosis and long-term management that is up-to-date and evidenced-based. We utilize leading-edge technology such as high-resolution 3-D imaging and printing to assist in planning for reconstructive surgery. The team works closely together to plan and coordinate any necessary treatments and surgical procedures to limit exposure to general anesthesia.
The team’s goal is to provide your child with a normal appearance, healthy teeth, good hearing, understandable speech and language, and a smooth transition into community settings like school, sports, etc. Our objective is to accomplish this with minimal disruptions in the family’s day-to-day life. We expect each child to grow up as a confident individual with the same opportunities for health, education, employment and social experiences.
Frequently Asked Questions
How long will my child be followed by the craniofacial team?
Each child is different, so the timing and frequency of visits may differ. In general, children need visits every one to two years so we can plan and coordinate treatment, and identify any problems in the areas of speech and hearing, dental health, education, and psychosocial needs.
How do I prepare my child for the craniofacial team visit?
Your child will be seeing multiple providers during the team appointment. Parents should be prepared for a lengthy visit, usually between one and two hours. Please bring snacks, drinks, any necessary baby supplies, as well as toys and electronics to keep your child entertained. You may also want to bring a calendar to schedule follow-up appointments and a notebook to write down important information (e.g., physician names and specialties, medical terms, special instructions).
Does insurance cover my child's care?
Most insurance companies and state Medicaid programs will cover surgical care for children with cleft or craniofacial abnormalities. We will do our best to work with your insurance plan to advocate for your child to receive all necessary medical care. Each insurance company is different and medical expenses can vary. It is important for families to be aware of the out-of-pocket expenses like annual deductibles and co-pays for office visits. If you are considering changing insurance companies, please note that it is very important for a family to contact a new insurance provider before they change insurance companies, to investigate whether coverage includes a preexisting condition clause.
Conditions We Treat
Cleft Lip and Palate
In a cleft lip, a split of the lip can extend up to the nose. Some infants have only an incomplete cleft, while others have a complete cleft, with an opening that goes from the red part of the lip through the bottom of the nose, spreading the nostril on the side of the cleft
Nasoalveolar Molding (NAM)
Before surgery for cleft lip repair, our specialists sometimes recommend an orthopedic treatment called nasoalveolar molding or NAM. This process reshapes the gum, lip, and nostrils with special dental molds and tape.
A cleft palate is a separation in the roof of the mouth that can start in the back of the palate, or just behind the gum line. A cleft palate is called complete when the separation in the roof of the mouth extends from the gum line to the back of the palate.
Pierre Robin Sequence
Some infants are born with a small lower jaw, which can affect the child’s ability to breathe normally. This is called Pierre Robin sequence (PRS).
Velopharyngeal dysfunction (VPD) occurs when the velopharyngeal valve — which comprises the soft palate, the pharynx, and the walls of the throat — doesn’t close properly. This causes problems with swallowing and speech.
Facial and Skull Deformities
Your child’s skull is made up of five major skull bones. Between them are growth plates called sutures. Craniosynostosis occurs when one or more of the sutures fuse abnormally, causing problems with skull and brain growth.
Plagiocephaly, also called flat head syndrome, is a common condition in which an infant’s soft skull develops flattening on the back of the head.
Hemifacial microsomia is a birth defect that affects the development of the lower half of the face, usually the mouth, the ears, and the lower jaw. If it’s severe, HFM may cause breathing problems due to obstruction of the windpipe.
Fibrous dysplasia (FD) is an uncommon bone disease characterized by areas of abnormal growth (lesions).
Facial Anomalies and Trauma
This includes animal bite injuries.
Ear Shape Deformities
Our doctors specialize in treating children who have complex ear deformities. Non-invasive ear molding is a treatment option for some infants with ear shape deformities. The molding involves the use of a customized piece of dental putty, surgical glue and adhesive tape to reshape the ear.
Complex Ear Deformities (Otoplasty)
Our doctors specialize in treating children who have complex ear deformities. In addition to the external deformity, microtia and anotia may cause hearing loss due to the closure or absence of the ear canal and ear drum.
Additional Conditions We Treat
Hemangiomas (Vascular Malformations)
A hemangioma, also called a “strawberry birthmark” or “strawberry nevus,” is made up of extra blood vessels that form a cluster. A hemangioma may be present at birth or may develop one to three weeks after birth. When hemangiomas interfere with sight, breathing, or hearing, they may be treated with medications, laser therapy, or surgery.
Neurofibromatosis is a genetic disorder that spurs growth of tumors in the nervous system. Tumors originate in the cells that make up the nerves and the membrane that protects them (called the myelin sheath).