Episode Transcript
Interviewer: We're here with Dr. Barbu Gociman, 他是犹他大学唇腭裂中心的颅面外科医生和医学主任. Dr. Gociman, 父母通常在什么时候发现他们的孩子可能患有唇裂或腭裂?
Dr. Gociman: Here in the United States, 大多数唇裂患者是在怀孕期间被诊断出来的. 这样父母就会知道孩子出生时会有兔唇. By contrast, when the babies have only a cleft palate, 通常超声诊断不明显，也不会在出生前做出诊断. So the diagnosis is made in the first day of birth.
Interviewer: 那么父母在孩子的头几个月需要做些什么来确保 . . . how early are they getting surgeries? What do they need to be doing the first couple months?
Dr. Gociman: Considering what the problems are, as we said, the lip, the gum, the hard and soft palate are involved. One of those structures or all of them, you can imagine the baby will have difficulty with feeding, with suckling. 如果唇裂存在，他们不能在乳头周围建立一个密封. 如果有腭裂，婴儿将很难发展吸力. 需要专门的设备来大发娱乐提供足够的热量摄入, 这意味着有足够的牛奶或配方奶粉来满足新生儿的需要.
Interviewer: When does the first surgery usually take place?
Dr. Gociman: For a cleft lip patient, if we assure adequate nutrition, there are no other anomalies associated with the condition, and the baby grows normally, the timing is approximately three months of age. 这样做的原因是婴儿已经足够大，能够承受麻醉而没有任何额外的风险, 所有与裂缝有关的结构都更大更坚固, and the operation is performed easier, 在手术过程中，物品破裂或其他并发症的风险更小.
Interviewer: 在你等待孩子变强壮的头三个月里会发生什么呢? Who should they be visiting?
Dr. Gociman: Here at the University of Utah, 大发娱乐有一个完善的系统来确保兔唇病人的所有需求都得到满足. For a cleft lip patient, the diagnosis is most of the time made prenatally, 所以父母已经和护士协调员进行了产前检查, with the physician assistant in charge of the cleft team, 和进行修复手术的颅面外科医生. So they already have a good idea of what is coming.
Once the baby is born, especially if it's born here, close, at the university hospital, or even at a hospital in close proximity, a cleft surgeon will visit with the family, evaluate the exact anatomy of the cleft, and start with the process of treatment. 这包括生命最初三个月的两个主要因素. One is assuring adequate feeding, and, as I said, 有不同的方式，通过这是实现专门的乳头, specialized bottles, 抱着婴儿防止反流的专门技术.
第二件同样重要的事情是大发娱乐所说的成型. We are trying to achieve normal anatomy. 因为嘴唇和上颚的肌肉缺乏连续性, 组成这些结构的元素可以相互迁移, and the anatomy becomes very difficult to recreate. 所以在生命的头三个月，大发娱乐试图把所有这些结构结合在一起. 大发娱乐试着重塑鼻子，嘴唇，牙槽和腭架.
Interviewer: 看来唇腭裂的治疗不仅仅是手术和重组. There's also speech. There's also feeding. There's also socialization. 在大发娱乐，有什么样的资源可以大发娱乐提供给一个有裂缝的新父母呢?
Dr. Gociman: We have a comprehensive cleft team. First, 大发娱乐在病人出生后立即检查，以确保足够的喂养和成型已经开始. And at the same time, 大发娱乐安排了一次诊所访问，让家人有机会与团队的所有成员一起访问. And each member has an important role in cleft care. So the team is made up of a cleft craniofacial surgeon, an ENT surgeon, pediatric orthodontist, a speech therapist, feeding specialist, and a social worker. 所以，这样做的原因是为了确保在裂缝中遇到的所有问题都能从一开始就得到解决，家庭对需要解决的所有步骤和所有因素都有一个完整的理解.
As such, the cleft surgeon will talk about a cleft repair, 根据病人的特殊解剖结构进行不同手术的顺序.
The ENT surgeon will talk about hearing. 大多数兔唇婴儿很难排出耳朵，并且中耳有严重感染，需要早期插管. Also, they have to assure later on that the speech is adequate, 以后可能会做语言矫正手术.
The orthodontist, as I said before, 最初将有非常重要的作用，在执行成型，然后, later on, in assuring eruption of the teeth, orthodontic work, and help with any orthodontic operations.
The speech therapist will be there, initially, to help with feeding, assure that the method that is most effective is used, and then, later on, as the speech starts developing, address any problems, involve the patient in speech therapy, and so forth.
Finally, 社会工作者在分离护理的所有步骤都在那里，只是为了解决可能出现的任何社会问题, 大发娱乐的唇腭裂患者会遇到很多问题. So it's a very useful component of the team.
Interviewer: So I understand that cleft care can be a long process. It's years and years of treatments and procedures. 但似乎这种类型的团队真的可以大发娱乐孩子和他们的家庭走上正确的道路，让他们开始，给他们一个进步.
Dr. Gociman: 一遍又一遍地证明，拥有一个专业的唇腭裂团队和拥有一个专业的唇腭裂团队是完全不同的. This is a standard across the United States. We are proud to have the largest, oldest, dare I say, the best team in Utah and in surrounding states. So we are getting patients from all the states around us. We pride ourself with our results, with innovation. We publish a lot. We are actively involved in research. 大发娱乐一直在努力改进大发娱乐的技术和结果. 大发娱乐对大发娱乐的结果非常挑剔，大发娱乐每次都试图取得完美的结果.