Craniomaxillofacial - Paediatric CPC

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Women's and Children's Health Network

• Women’s and Children’s Hospital (08) 8161 7000

Category 1 - appointment clinically indicated within 30 days

• craniofacial trauma
• visual or feeding compromise, neurological symptoms, or potential airway involvement

Category 2 — appointment clinically indicated within 90 days

• craniomaxillofacial deformity
• delayed presentation facial fractures
• dentofacial deformity
• growth disturbances
• other maxillary and mandibular growth disorders where there is an established craniomaxillofacial diagnosis
• syndromic craniosynostosis
• Treacher Collins syndrome (TCS) and related conditions

Category 3 — appointment clinically indicated within 365 days

• nil

For information on referral forms and how to import them, please view general referral information.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

• identifies as Aboriginal and/or Torres Strait Islander
• identify within your referral if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf
  
• interpreter requirements
• child/parents demographic information including best contact details
• past medical history
• current medications and dosages
• allergies and sensitivities
  
• presenting symptoms, evolution and duration
• craniofacial disorder symptoms including:
  • difficulty with chewing or swallowing. symptoms must be documented by the referring doctor and must have persisted for more than 12 months.
  • documented significant weight loss, malnutrition, or failure to thrive secondary to facial skeletal deformity
• dentofacial deformity symptoms including:
  • severe class ii malocclusion with an overjet of greater than 9 mm
  • severe class iii malocclusion with a negative overjet of greater than 3.5 mm
  • anterior open bite greater than 4 mm
  • documented speech impairment that is the result of a poor bite or jaw positioning following assessment and confirmation by speech pathologist
• obstructive sleep apnoea (OSA) diagnosis confirmed by respiratory/sleep physician who have failed the following:
  • trial of continuous positive airway pressure (CPAP) device
  • less invasive surgical procedures
• OSA diagnosis confirmed by respiratory/sleep physician, with skeletal anomalies associated with narrowed upper airways

Previously diagnosed patients

• previous surgical/medical management and treatment summary - including outcome of the treatment

Additional information to assist triage categorisation

• photograph, including disposable measurement tool – with patient’s consent, where secure image transfer, identification and storage is possible
• relevant reports and summaries from clinician involvement in medical management

Clinical management advice

Craniosynostoses have a wide range of urgency and early referral is helpful.

If the patient requires urgent attention and/or fulfils category 1 triage criteria, please contact the on-call registrar to discuss and ensure your referral has been received.

Orthognathic surgery (OGS), or corrective jaw surgery is available to patients treated by Cleft & Craniofacial SA at both the Women’s and Children’s Hospital (WCH) and the Royal Adelaide Hospital (RAH).

This is a guideline for outpatient referral only. If you have clinical concerns, please contact the WCH Cleft & Craniofacial SA service via switchboard on (08) 8161 7000

Clinical resources

• WCH – Cleft and Craniofacial SA
• Therapeutic Guidelines - Initial Assessment and Management of Maxillofacial Trauma

Consumer resources

• Children’s Craniofacial Association