Consultant Cleft Surgeon
Mr. Alistair Smyth
Alistair Smyth is the Cleft Surgeon and Lead Clinician for the cleft team based in Leeds. He specialises in surgery for cleft lip and palate and carries out between 150 to 200 operations each year on children and young adults. His background training is in oral and maxillofacial surgery. He was appointed to the post of lead cleft surgeon in Leeds with the Northern and Yorkshire cleft lip and palate service in 2002.
Mr Smyth carries out all aspects of cleft surgery from primary repair in babies through to secondary surgery in adults. Although Mr Smyth sees patients on out-patient clinics throughout the Yorkshire region, if surgery is needed, then this is carried out for under 16 year olds at Leeds Children’s hospital, adults at Leeds General Infirmary.
Mr Smyth is also a recognised trainer in cleft surgery for junior surgeons who wish to specialise in this area of surgery. He was awarded the British Association of Oral and Maxillofacial Surgeons (BAOMS) prize in recognition of his outstanding contribution to the specialty. He is an active member of national societies and committees concerned with the advancement of clinical care for cleft lip and palate patients and the continuing education of multi-disciplinary cleft team members.
Clinical Nurse Specialists
- Emma Blair (Speciality Lead Clinician)
- Sarah Stringer
- Suzanne Dickins
The Clinical Nurse Specialists (CNSs) have a wide knowledge and experience of children’s nursing, including care of children born with cleft lip and/or palate. They are usually the first member of the regional cleft team that you meet if you have a baby with a cleft lip/palate. We meet you following diagnosis and referral, whether you have been referred antenatally, or following the birth of your baby.
Your CNS will contact you as soon as a referral is received and provide you with information, expert knowledge and advice about what to expect on your child’s cleft journey. They provide ongoing specialist advice and support, regarding your baby’s cleft lip and/or palate, from the initial diagnosis to the teenage years. Your CNS has expert knowledge in feeding assessment and management, pre-and post-operative care, and all other aspects of cleft care including access to other support services within the cleft team and at our outreach hospitals.
The CNS team aim to visit all new-born babies within 24 hours of birth. The team provide a 365 day-a-year service. If your own CNS is not available, their mobile phone will divert to another member of the CNS team.
The Speech and Language Therapy Team
- Samantha Calladine (Speciality Lead Clinician)
- Andrea Malatesta
- Susie Powell
- Tanya Pipkin
- Kay Jeffrey
- Keeley Cutts
- Kirsty Minshull
- Cat Larham
If your child was born with a cleft palate, or a cleft lip and palate, members of the Speech and Language Therapy team will work with you and your child from around six months of age. They will provide information and advice to help you to understand the possible differences you may see in your child’s speech and language development, and share how you can support your infant’s developing communication. Once your child is slightly older they will monitor their speech and language development at routine intervals, and share information about what they are hearing with the Cleft Surgeon and other members of the team. They work closely with other members of the cleft palate team to ensure the best possible care for your child.
They will contact you periodically when you child is between six months and three years of age, appointments are a combination of virtual parent group sessions, virtual 1:1 sessions, and face to face sessions.
Therapists may see your child for more regular speech therapy support if they need it. They work closely with Speech and Language Therapists around the Yorkshire region and, if appropriate, will organise therapy in your local area.
Clinical Psychologists
- Dr Andrea Gaston (Speciality Lead Clinician)
- Dr Alex Houston
- Dr Wendy Walker
- Ms Nicole Russell (Assistant Psychologist)
There are several clinical psychologists who work within the Team. They offer support to patients and families throughout infancy, childhood, adolescence and adulthood. A psychologist is always present in clinic to offer support and advice and they can also be accessed at any time to offer telephone support or meet with patients and families individually.
The psychologists can offer help with a range of issues. They can offer support regarding the emotional impact of having a cleft lip and palate, support throughout treatment and surgery and help with making decisions about treatments in the future.
They are present at your routine multidisciplinary clinic appointments to offer general advice and discuss any concerns. They can arrange individual appointments if needed, via telephone, video consultation or face to face.
Consultant Orthodontists
- Mrs Fiona Jenkins (Speciality Lead Clinician) – St Lukes Hospital Bradford
- Mr James Spencer – Pinderfields Hospital, Wakefield
- Ms Jennifer Rae – York Hospital
- Mr Trevor Hodge – Leeds Dental Institute
The Specialist Orthodontists will see any child with a cleft that might affect their teeth. This is done periodically in clinic from around the age of 5. What kind of orthodontic treatment a child needs depends largely on whether or not their cleft affects the alveolus. Children born with a cleft that went through the gum and affects their teeth will usually need more extensive orthodontic treatment.
After the majority of permanent adult teeth have come through in early adolescence, the orthodontist will look at any issues such as missing, irregular or discoloured teeth and work closely with the dentists and surgeons in the Cleft Team to see what can be done about any problems. Treatment for these will depend on the child’s individual needs, and might include braces, crowns, and even surgery to realign the jaws in their late teens.
Paediatric Dentist
- Dr Rosemary Bryan (Speciality Lead Clinician) – Leeds Dental Institute
- Dr Rachael Nichol – Pinderfields Hospital, Wakefield
- Dr Elizabeth O’Sullivan – Hull Royal Infirmary
The Paediatric Dentistry team will review children in clinic periodically from the age of 3 to 16 years. They have a specialty interest in caring for children with cleft lip and/or palate and will offer advice and support to children and families. It is sometimes required for the paediatric dentistry team to see infants if there is a concern around first teeth.
Paediatric Dentists will aim to prevent tooth decay and therefore prevent pain as well as the need for fillings or extractions. This helps to maintain the bone in which the teeth are embedded and will make orthodontic treatment easier. Your family dentist should be aware of any issues caused by your child’s cleft, and can advise them on how to prevent tooth decay, it is very important your child is registered with their own dental practice (family dentist) who will work in conjunction with the paediatric dentistry team as needed.