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The establishment of a craniofacial in a developing country is often difficult because of the availability of trained personnel. This requires gradually replacing or training personnel such as speech pathologists. Gradual improvement is possible for a period of 5 to 10 years to train individuals. This requires a dedicated person to achieve the goal of a multidisciplined center for patients with cleft.

A combined cleft palate and craniofacial was organized at Chang Gung Memorial Hospital, Taipei, in 1980. The team includes four plastic surgeons, four orthodontists, one prosthodontist, one otolaryngologist, one pediatrician, two speech pathologists, one social worker, one psychologist, two neurosurgeons, one ophthalmologist and a medical artist. Weekly combined clinics and meetings are held regularly to evaluate cleft lip/palate and all craniofacial cases. The team members set up treatment plans for each cleft palate and craniofacial patient, and follow up the patient's facial growth with critical evaluation of the result, complication, relapse and patient's or parent's satisfaction after surgery. Parents' support groups, summer speech camps and conferences between patients, parents and other public resources are held regularly. Longitudinal studies are strictly carried out on specific groups of cleft patients and major craniofacial patients.

Of 2963 patients registered at the Chang Gung Craniofacial Center, 1755 patients (906 males and 849 females) who did not have any previous surgery were carefully delineated according to cleft side, involvement of primary or secondary palate and severity of cleft. Cleft lip and palate (43.88%) was the most common cleft, cleft palate (30.88%) the second, while cleft lip (25.24%) the least. More males were found in cleft lip group or cleft lip and palate group, and more females in the cleft palate group. Regarding clefts involving both primary and secondary palates, the cleft of both palates was usually complete, but when the clefts involved either the primary or secondary palate, the cleft was usually incomplete. With regards to the laterality of unilateral cleft lip and/or palate, the left side was affected more than right side. With regard to seasonal variation, cleft palate patients showed the highest incidence from August to October and the lowest incidence from November to January. Cleft lip or cleft lip and palate patients showed the highest incidence from November to February but no obvious difference in the rest of the months. Topographic distribution disclosed that more patients were domiciled in the area north to Hsien-Chu, especially the urban Taipei area.