One child in 2,000 in the United States has a misshapen head resulting from a birth defect in which the bones of the skull prematurely close. The condition, called craniosynostosis, can constrict growth of the child's brain and lead to vision problems. An improved treatment option at Morgan Stanley Children's Hospital of NewYork-Presbyterian gives surgeons greater control in reshaping the skull.
Traditionally, craniosynostosis was treated using metal screws and plates. Now, pediatric plastic surgeons use absorbable plates made of a combination of polyglycolic and polylactic acid that are absorbed by the body much like surgical sutures. These plates can be placed wherever is necessary -- including the forehead bone. In contrast, surgeons traditionally avoided placing metal plates in the forehead because they would be palpable, and could cause contour irregularities. Another advantage is that absorbable plates do not interfere with x-rays as do metal plates and screws.
Surgery for craniosynostosis is usually performed in the first six months of the child's life for several reasons, including the fact that the bones of the skull are easier to work with at this age. Moreover, the growing brain can continue to reshape the skull and face after the surgery.
"Deformities like a misshapen head can be very traumatic for parents," says Dr. Jeffrey Ascherman, director of the Division of Plastic Surgery and director of the Cleft/Craniofacial Center at Morgan Stanley Children's Hospital of NewYork-Presbyterian and associate professor of clinical surgery at Columbia University College of Physicians and Surgeons. "It is important for the child's pediatrician to detect the condition early and for parents to seek the best specialized care for their child."
Diagnosis of craniosynostosis is done by a pediatric neurosurgeon and plastic surgeon. The causes of craniosynostosis are usually not known. It occurs in many syndromes, including Apert's, Crouzon's and Pfeiffer's syndromes. However, a distorted head at birth does not always result from craniosynostosis and may require other non-surgical interventions.
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Comprehensive and Specialized Treatment Available for Clefts and Other Common Defects
The most common facial defect and the fourth most common birth defect is cleft lip or palate. One child in 700 is born with a cleft, which can range in severity from mildly disfiguring to severe with complications including problems with feeding, ear disease and speech.
Treatment for clefts requires a multidisciplinary team that can comprise plastic surgery, neurosurgery, ophthalmology, ENT, oral surgery, orthodontics, pediatric dentistry, genetics, pediatrics, speech and language therapy and physical therapy.
Other common pediatric conditions that require treatment with plastic surgery include hypertelorism (eyes set too far apart), hand defects, blood-vessel malformations, ear and nose deformities, facial fractures and scarring, among others.
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