This guide is centre-neutral. It is intended for all healthcare professionals in Switzerland and is independent of the treating centre. Referral should ideally be made to one of the specialised university centres (→ see list below).
Cleft lip and palate (CLP) and craniofacial anomalies require an experienced, interdisciplinary specialist team. Early referral — in some cases already prenatally — is crucial for optimal outcomes and family preparation.
Immediate referral / emergency contact. Cannot wait for a scheduled appointment. Contact neonatology or the on-call maxillofacial surgeon directly.
Refer within days. The time window is clinically significant — delays may limit treatment options.
Refer within 2–4 weeks. No immediate emergency, but early assessment is recommended.
No time pressure. Patient and family should still be informed that a specialist consultation is recommended.
| Diagnosis / Situation | Timeframe | Urgency | Notes |
|---|---|---|---|
| Pierre Robin sequence with airway obstruction | Immediately | 🔴 Emergency | Contact neonatology or MFS on call directly. Airway management is priority. |
| Severe craniosynostosis with signs of raised ICP | Immediately | 🔴 Emergency | Neurosurgical co-assessment required without delay. |
| Newborn with CLP (postnatal) | Within 1–2 weeks | 🟠 Urgent | Feeding counselling, specialist bottle fitting, palatal plate. Early appointment greatly reassures the family. |
| Prenatal CLP diagnosis (ultrasound week 20–22) | Before birth | 🟠 Urgent | Prenatal counselling enables birth planning and parental preparation. |
| Isolated cleft palate (detected postnatally) | Within 2–4 weeks | 🟠 Urgent | Often only identified after birth. Feeding difficulties are the primary concern. |
| Craniosynostosis (suspected, no ICP signs) | Within 2–4 weeks | 🟡 Soon | Low-dose CT if available (include with referral). Differential: positional plagiocephaly. |
| Plagiocephaly — synostosis not excluded | Within 4–8 weeks | 🟡 Soon | Clinical differentiation can be difficult. Early assessment preserves treatment options. |
| School-age child: alveolar bone graft timing | Orthodontic referral before age 8 | 🟢 Elective | Optimal timing: canine root 50–75% formed, typically age 9–11. |
| Adolescent / adult: jaw surgery, rhinoplasty, implants | After skeletal maturity (≥ 17–18 yrs) | 🟢 Elective | Pre-surgical orthodontics required. Joint planning with orthodontist. |
Alphabetical by city, no order of preference.
University Hospital Basel (USB) & UKBB
Inselspital, University Hospital Bern
Geneva University Hospitals (HUG)
Centre hospitalier universitaire vaudois (CHUV)
University Hospital Zurich (USZ) & Children's Hospital Zurich (Kispi)
Early referral is advisable if craniosynostosis, syndrome-associated anomalies, a Robin sequence or relevant airway or feeding problems are suspected. In newborns with airway obstruction, referral is urgent.
The choice depends on the clinical question and the child's age; radiation-protection aspects are especially important in children. The specific indication is set individually by the specialist centre.
Timing and sequencing depend on diagnosis, growth and function and follow established but individually adapted care pathways. Interdisciplinary planning is recommended.