Working life: Christoph Theopold, consultant cleft surgeon
Left unrepaired, cleft palates can cause major feeding difficulties in infancy, leading to slower growth and also strongly affect their speech development, which has consequences for their social integration.
I specialised in cleft surgery at Great Ormond Street Hospital before taking over a well-established cleft service in Temple Street last year.
Since starting, the whole cleft team has made great strides in reducing the waiting time for children with speech problems that require surgery.
Tuesday is theatre day so I go to see the children before their operation. Their pre-op assessments will have been conducted the previous Friday by myself and our cleft nurse.
I imported this concept from Great Ormond Street and found it gives parents more time to ask questions and reduces the number of surgery cancellations on the day due to illness, allowing us to maximise theatre list time.
I generally carry out about four operations on theatre day.
Babies usually have their lip repaired at three months and their palate at nine months.
Some children with repaired palates may require further surgery if their palate has not healed properly first time or the palate is not functioning well enough to make the required speech sounds.
There is no formal lunchbreak, so I have sandwiches between cases.
On Wednesday afternoons, I have a commitment to the cleft clinic at St James’s Hospital.
On Thursdays I perform adult cleft lip/ palate surgery in the Mater Hospital.
We look after our cleft patients until after they have stopped fully growing and expect to do touch-up operations as late as 20 years of age. This can include operations on the lip and nose, as well as the jaws by our maxillofacial colleagues.
I do a ward round to check how my patients are doing and to see if their parents are happy. I usually have a bit of paperwork to do. Some evenings I work late, especially if I’m doing head and neck reconstruction at the Mater Hospital.
I’ll go for a walk in the park with my wife or a cycle. I usually have a bit of planning to do around the Temple Street service.
* Christoph Theopold, consultant cleft surgeon, Temple St Children’s Hospital.


