Burden-Reduced Cleft lip and palate Care and Healing

Every 700th birth worldwide is affected by any type of uncompleted development of the upper lip and palatal prominences leading to orofacial cleft (cleft lip and palate). In absence of early surgical correction, main concerns are social discrimination by the disfiguration, nasal leakage of food leading to failure to thrive adequately, and impossibility of speech development. No effective preventive measures exist. Currently, two principles are used and commonly applied complementary as treatment strategies: (1) a palatal plate therapy after birth to keep the tongue out of the cleft space and to narrow the palatal cleft and (2) a multi-step surgical repair. However, this strategy necessitates a palatal impression that endangers the child’s airway and a high surgical burden. The project therefore develops a non-invasive strategy for the palatal plate therapy followed by a one-step surgical repair of the entire cleft lip and palate malformation.

With the use of machine learning algorithms, smartphone-based images of the palate malformation, and 3D printing of tailor-made palatal orthopaedic plates, this project will potentially revolutionise the standard course of treatment of cleft lip and palate. We aim to reduce burden on the patient receiving the cleft lip and palate surgical treatment and to improve the overall long-term outcome. We will exploit our surgical expertise and 3D morphometric knowledges, combined with artificial intelligence to simplify the treatment procedure by developing a ground-breaking new cleft treatment regime:

1. Image-based, non-invasive palatal shape reconstruction with the aid of smartphones and a software program based on artificial intelligence 
2. Use of 3D printing (Zarean et al. 2022) following the automated palatal plate design (Schnabel et al. 2023) to simplify the production process
3. Replace multiple surgical steps with one single surgical intervention through use of the palatal plate (passive plate therapy)

Achieving these goals would provide us with a passive, pre-surgical treatment that is physically, technologically and economically realizable worldwide including in low- and middle-income countries, therefore ultimately enable promotion of single-step surgical treatment to replace the widely performed multi-step surgical treatment which impose large burden on the children and their families.