Thomas J. Sitzman, MD, Editor

Jeffrey R. Marcus, MD, Editor

Readers may ask if any new information exists in cleft care; the answer is a resounding YES. Our understanding of genetic contributions to cleft lip and palate continues to evolve, giving order to the spectrum of deformities surgeons encounter. There is growing recognition for the importance of anatomic reconstruction of the velar musculature during cleft palate repair. There are new instruments for measuring speech outcomes, and a structured approach to managing velopharyngeal insufficiency is evolving. Controversy around naso-alveolar molding grows, accompanied by a resurgent interest in gingivoperiosteoplasty. These developments are changing how we care for all children with cleft lip and palate, and each is addressed in this issue of Clinics in Plastic Surgery .

Cleft care continues to advance both in how we approach all patients and in our understanding of the nuanced approach necessary for each patient. This issue includes articles detailing approaches to patients with 22q11.2 deletion syndrome and Pierre Robin sequence. These articles highlight the unique features of each condition, including how the treatment approach should be adapted.

Coupled with the evolution in surgical approaches, there is a growing appreciation for the role of outcome measurement in cleft care. The last two decades have witnessed the birth of intercenter outcome comparisons, multinational randomized clinical trials, and the incorporation of outcome reporting into standard care delivery. Each article in this issue includes a discussion of appropriate outcome measures, including the what, when, and how of applying them. This information is of widespread importance as outcome reporting becomes integrated with clinical care.

We are grateful to Elsevier for the opportunity to be guest editors to this issue of Clinics in Plastic Surgery . We are indebted to each of the authors for their valuable contributions, taking time from their professional and personal lives to share their insights. The editorial staff of The Clinics is outstanding, in particular, our senior editor, Joanne Husovski. Finally, we would like to thank our wives and families for their understanding and support during this project.