Cleft Palate and Craniofacial Conditions: A Comprehensive Guide to Clinical Management

Cleft Palate and Craniofacial Conditions: A Comprehensive Guide to Clinical Management, Fifth Edition continues to set the standard as the most in-depth and clinically relevant text on the subject. Written by renowned clinician, educator, and researcher Ann W. Kummer, this extensively updated edition combines foundational science with practical, evidence-based clinical application for the assessment and management of cleft palate, craniofacial conditions, and velopharyngeal dysfunction.

Designed for graduate-level instruction and interdisciplinary clinical practice, the fifth edition provides a clear, sequential approach that helps readers build knowledge from anatomy and genetics through assessment, treatment, and team-based care. Richly illustrated and supported by hundreds of clinical photographs, diagnostic images, and online videos, this trusted text bridges the gap between theory and real-world clinical decision making.

Drawing on decades of clinical and teaching experience, Dr. Kummer presents not only the “what” and “why” of craniofacial management, but also the critical “how” that clinicians need for accurate diagnosis, effective treatment planning, and successful intervention. Comprehensive yet highly practical, this text remains an essential resource for graduate students, speech-language pathologists, craniofacial team members, and other healthcare professionals who work with individuals affected by clefts and craniofacial conditions.

New to the Fifth Edition

• Expanded coverage of speech, resonance, and velopharyngeal dysfunction, including additional clinical strategies for both assessment and treatment
• Updated chapters on genetics, craniofacial syndromes, developmental and psychosocial considerations, and surgical management, with contributions from experts across multiple craniofacial disciplines
• Additional evidence-based speech therapy strategies and practical guidance for achieving carryover through the use of motor learning and motor memory principles
• Revised organization, streamlined presentation, and the addition of many summary tables for improved readability, clarity, and comprehension
• New clinical photographs, illustrations, and diagnostic examples throughout the text
• Enhanced online learning resources and video content to support both classroom instruction and independent study

Key Features

• Comprehensive coverage of cleft palate, craniofacial anomalies, resonance disorders, and velopharyngeal dysfunction across the lifespan
• More than 700 full-color photographs, illustrations, tables, and diagnostic images that enhance understanding of complex concepts
• Nearly 300 online clinical videos demonstrating speech disorders, instrumental evaluations, surgical outcomes, and therapy techniques
• Practical “how-to” guidance for speech assessment, differential diagnosis, treatment planning, and intervention
• Chapter outlines, case studies, “Speech Notes,” discussion questions, and “Cleft Notes” worksheets that enhance learning and reinforce clinical reasoning
• Extensive glossary of terms

PluralPlus Online Ancillaries

For instructors: PowerPoint Slides, Recorded Lectures, Test Bank, Image Bank, Videos, Syllabus, “Cleft Notes”
For students: Videos, Forms/Documents, “Cleft Notes”

Contents

Preface
About the Author
Contributors
Key to Phonetic Symbols

Part 1: Normal and Abnormal Craniofacial Structures

Chapter 1: Anatomy and Physiology
    Introduction
    Craniofacial Structures
    Intraoral Structures
    Pharyngeal Structures
    Velopharyngeal Valve
    Variations in Velopharyngeal Closure
    Subsystems of Speech: Putting It All Together
    Summary
    For Review and Discussion
    References

Chapter 2: Genetics and Patterns of Inheritance
    Introduction
    Cell Anatomy
    Deoxyribonucleic Acid and Genes
    Chromosomes
    Mendelian Inheritance
    Multifactorial Inheritance
    Summary
    For Review and Discussion
    References

Chapter 3: Clefts of the Lip and Palate
    Introduction
    Embryological Development
    Clefts of the Primary Palate
    Clefts of the Secondary Palate
    Submucous Cleft Palate
    Facial Clefts
    Causes of Clefts
    Incidence of Clefts
    Summary
    For Review and Discussion
    References

Chapter 4: Dysmorphology and Craniofacial Syndromes
    Introduction
    Dysmorphology
    Craniofacial Syndromes and Conditions
    Craniosynostosis Syndromes
    The Genetics Evaluation
    Summary
    For Review and Discussion
    References

Chapter 5: Facial, Oral, and Pharyngeal Conditions
    Introduction
    Ear Conditions
    Facial Conditions
    Intraoral and Pharyngeal Structures
    Upper Airway Obstruction
    Summary
    For Review and Discussion
    References

Chapter 6: Dental Anomalies and Malocclusion
    Introduction
    Normal Dentition and Dental Occlusion
    Dental Anomalies
    Normal Skeletal Occlusion and Skeletal Malocclusion
    Dental Development and Stages of Treatment
    The Role of Speech Therapy
    Summary
    For Review and Discussion
    References

Part 2: Functional Effects of Clefts and Craniofacial Anomalies

Chapter 7: Feeding Problems of Infants With Clefts or Craniofacial Anomalies
    Introduction
    Infant Feeding and Early Development
    Feeding Problems Caused by Clefts and Other Craniofacial Conditions
    Feeding Information for Parents and Caregivers
    Breastfeeding
    Bottle-Feeding
    Facilitation Techniques
    Assessment of Feeding Problems
    Summary
    For Review and Discussion
    References

Chapter 8: Developmental Aspects: Speech, Language, and Cognition
    Introduction
    Prerequisites for Normal Development
    Development of Children with Clefts and Craniofacial Syndromes
    Summary
    For Review and Discussion
    References

Chapter 9: Psychosocial Aspects of Cleft Lip/Palate and Craniofacial Conditions
    Introduction
    Family Concerns
    School Issues
    Societal Issues
    Behavior and Mental Health Issues
    Summary
    For Review and Discussion
    References

Chapter 10: Resonance Disorders and Velopharyngeal Dysfunction
    Introduction
    Voice, Resonance, and Airflow
    Resonance Disorders
    Velopharyngeal Dysfunction
    Speech Characteristics of Velopharyngeal Insufficiency/Incompetence
    Treatment of Velopharyngeal Insufficiency/Incompetence
    Summary
    For Review and Discussion
    References

Part 3: Assessment Procedures: Speech, Resonance, and Velopharyngeal Function

Chapter 11: Perceptual Evaluation of Speech, Resonance, and Velopharyngeal Function
    Introduction
    Timetable for Assessment
    Procedures for a Comprehensive Evaluation
    What to Assess
    Supplemental Procedures for Evaluation of Resonance and Velopharyngeal Function
    Analysis and Follow-Up
    Summary
    For Review and Discussion
    References
    Appendix 11–1

Chapter 12: Orofacial Examination
    Introduction
    Effects of Dysmorphology on Aesthetics and Function
    Methods for Conducting an Intraoral Examination
    Key Observations During an Examination
    Infection Control During the Examination
    Summary
    For Review and Discussion
    References

Chapter 13: Overview of Instrumental Procedures
    Introduction
    Indirect Procedures
    Direct Procedures
    Summary
    For Review and Discussion
    References

Chapter 14: Nasometry
    Introduction
    History of Nasometry
    Nasometry Overview
    Nasometric Procedures
    Interpretation of Nasometric Results
    Uses for Nasometry
    Summary
    For Review and Discussion
    References
    Appendix 14–1
    Appendix 14–2
    Appendix 14–3
    Appendix 14–4

Chapter 15: Videofluoroscopy
    Introduction
    History of Radiography for Evaluation of Velopharyngeal Function
    Videofluoroscopy Overview
    Videofluoroscopy Procedures
    Clinical Observations and Documentation of Findings
    Advantages and Limitations of Videofluoroscopy
    Summary
    For Review and Discussion
    References

Chapter 16: Nasopharyngoscopy
    Introduction
    History of Endoscopy Use for Velopharyngeal Function
    Nasopharyngoscopy Overview
    Nasopharyngoscopy Preparation
    Nasopharyngoscopy Procedure
    Clinical Observations and Documentation of Findings
    Advantages and Limitations of Nasopharyngoscopy
    Cleaning and Storing the Endoscope
    Summary
    For Review and Discussion
    References
    Appendix 16–1: Coloring Book Pages
    Appendix 16–2: Nasopharyngoscopy Examination Form

Part 4: Treatment Procedures: Speech, Resonance, and Velopharyngeal Dysfunction

Chapter 17: Surgical Management in Cleft Lip and Palate
    Introduction
    Cleft Lip Repair
    Cleft Palate Repair
    Surgery for Velopharyngeal Insufficiency
    Alveolar Bone Grafting
    Oronasal Fistula Repair
    Orthognathic Surgery and Distraction Osteogenesis
    Summary
    For Review and Discussion
    References

Chapter 18: Prosthetic Management
    Introduction
    Prosthetic Devices and Their Uses
    Facial Devices
    Dental Devices
    Feeding Devices
    Speech Devices
    Advantages and Disadvantages of Prosthetic Management
    Summary
    For Review and Discussion
    References

Chapter 19: Speech Therapy
    Introduction
    Timetable for Speech Intervention
    Interventional Planning for Speech Disorders due to Velopharyngeal Insufficiency
    Speech Therapy General Principles
    Effective Speech Therapy Techniques
    Methods and Tools for Biofeedback
    Use of Motor Learning and Motor Memory Principles
    Summary
    For Review and Discussion
    References
    Appendix 19–1

Part 5: Interdisciplinary Care

Chapter 20: The Team Approach
    Introduction
    Need for Team Management
    Characteristics of Teams
    Team Interactions
    Resources for Services
    Summary
    For Review, Discussion, and Critical Thinking
    References

Chapter 21: Cleft Care in Low- and Middle-Income Countries
    Introduction
    Incidence of Clefts in Low- and Middle-Income Countries
    Global Barriers to Accessing Cleft Care
    Evolution of Global Cleft Care
    Surgical Outreach in Global Cleft Care
    Summary
    For Review and Discussion
    References
    Appendix 21–1: Preparing for International Travel

Glossary
Index

Cleft Palate and Craniofacial Conditions: A Comprehensive Guide to Clinical Management, Fifth Edition comes with access to supplementary student and instructor resources on a PluralPlus companion website.

The companion website is located at: https://www.pluralpublishing.com/publication/cpcc5e

STUDENTS:

The student resources include Videos, Forms/Documents, and “Cleft Notes”.

To access the student resources, you must register on the companion website and log in using the access code located in the front of your textbook.

INSTRUCTORS:

The instructor resources include PowerPoint Slides, Recorded Lectures, Test Bank, Image Bank, Videos, Syllabus, and “Cleft Notes”. You will also have access to all of the student resources listed above.

To access the instructor resources, you must contact Plural Publishing, Inc. to be verified as an instructor and receive your access code.

            Email: instructormaterials@pluralpublishing.com

            Tel: 866-758-7251 (toll free) or 858-492-1555

*Note for students: If you have purchased this textbook used or have rented it, your access code will not work if it was already redeemed by the original buyer of the book. Plural Publishing does not offer replacement access codes for used or rented textbooks.