Even among those less severely affected, surgical excision of lip pits is often performed, either to alleviate discomfort or for cosmetic reasons, such as improving the appearance of lip pits or reducing mucous discharge. Management of children with cleft palate is often best performed by a multidisciplinary team of pediatric plastic surgeons, dentists, otolaryngologists, geneticists, genetic counselors, social workers, and occupational, speech, and physical therapists. Although Van der Woude syndrome is transmitted by an autosomal dominant inheritance pattern, the degree of expression in affected families is quite variable. Due to the variable expressivity of the phenotype the potential effects on unborn children is difficult to predict and may be of particular concern to parents. High-resolution ultrasounds and fetal echocardiography may be of some use in prenatally characterizing the severity of the phenotype.
Genetic counseling is recommended.
Cleft palate may be associated with feeding difficulties, voice disorders, frequent otitis media, and hearing loss. Lip pits may be associated with other disorders, including popliteal pterygium syndrome and orodigitofacial dysostosis. Although any lip pits should at least suggest Van der Woude syndrome, not all children with lip pits have the syndrome. Midline pits are unusual and often sporadic events, as are pits of the upper lip. There have been reports of children with cleft lip and palate, lip pits, and complex congenital heart disease who did not have family histories suggestive of Van der Woude syndrome.