Craniofacial Surgery in Children

Houston Plastic and Craniofacial Surgery

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Craniofacial Surgery in Children

Craniofacial surgery deals with the correction and reconstruction of malformations to face or skull by birth.

Craniosynostosis and cleft lip and cleft palate are the two common conditions treated with craniofacial surgery. The plan for the surgery is made as early as 8 or 9 months of age, or as soon as the problem is recognized.

Treatment depends on the severity and the type of the condition as diagnosed by the plastic surgeon.

Craniosynostosis This is a condition in which the bones of the skull fuse together prematurely. The human skull is made up of a collection of different bones that fit together and the areas where the bones meet are called ‘sutures’.

In babies with this condition, as the brain grows in size, it pushes against the bones of the skull, causing the skull bones to expand and grow. When

Houston Plastic and Craniofacial Surgery

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one of these sutures closes or is fused too early, growth is restricted. This growth restriction in one area may causes overgrowth in other areas resulting in an abnormallyshaped skull.

Types •

Sagittal Synostosis: Sagittal Synostosis is the most common type of this condition. It occurs when the suture in the midline of skull that runs right along the top of the head fuses early. This may cause the head to appear long and narrow with or without bulging of both the front and back of the head.

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Coronal Synostosis: Coronal Synostosis is a condition characterized by premature fusion of either the right or left side of the coronal suture. This causes the brow on the affected side to be higher than the other side, making that eye appear larger and the tip of the nose to appear deviated to the other side.

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Metopic Synostosis: The condition occurs due to premature fusion of the metopic (forehead) suture.

Early closure of this suture may result in a prominent ridge running down the forehead. In certain cases, the forehead looks pointed, like a triangle with closely placed eyes.

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Multiple Suture Synostosis: Multiple suture synostosis involves multiple types of sutures rather than just one.

Houston Plastic and Craniofacial Surgery

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Treatment Options Two common surgical craniosynostosis are:

procedures

to

correct

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Endoscopic Synostosis Repair: Endoscopic synostosis repair make use of an endoscope to correct the deformity. Through small incisions, portions of the skull bone are removed over the fused suture. This form of surgery is usually performed when the baby is less than 3 months old.

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Cranial Vault Remodeling: Cranial vault remodeling is usually performed on older children. An incision is made in the scalp and the bones of the skull are reshaped by expanding and enlarging the space within the vault, allowing the brain to grow more naturally.

Cleft Lip and Cleft Palate Cleft lip and cleft palate are common birth defects that occur at a very early stage of pregnancy. Cleft lip is characterized by an opening in the upper lip which happens when the tissue that makes up the lip does not join completely. A cleft palate occurs when the tissue that makes up the roof of the mouth does not join together completely. These

Houston Plastic and Craniofacial Surgery

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deformations can cause feeding, speech, ear and dental problems.

Treatment for Cleft lip and Cleft Palate More than one surgery is usually needed to correct cleft lip and palate. Prior to surgery, some orthodontic treatment is required to guide the growth of the mouth in the right direction. Nasal alveolar molding (NAM) can reduce the number of surgeries required during the patient’s lifetime.

With this technique, it is possible to: • Repair the cleft lip by bringing edges closer • Correct nasal deformity and create a natural-looking nose • Reposition the alveolar ridges and restore its normal anatomic alignment • Improve the postsurgical results For best results with delicate reconstructive procedures such as these, it is crucial to consult an experienced plastic surgeon at an AAAASF accredited surgical center.