Pediatric Plastic Surgery For Craniofacial Anomalies

Health & Medical Blog

When a child is born with one or more craniofacial anomalies, a team of medical professionals works together to diagnose, treat, and provide follow-up care and therapy. Plastic surgeons play a key role in treating these conditions by surgically correcting structural problems to improve functionality and cosmetic irregularities.

Some of the craniofacial anomalies that may require plastic surgery include cleft palate, cleft lip, craniosynostis, hemifacial microsomia, and microtia.  Cleft palate and cleft lip occur when the tissues that form the oral palate and lips do not fuse together during fetal development, resulting in a fissure in the oral cavity or an external fissure between lips and nose. These conditions can cause problems with feeding, tooth development, speech, and hearing. Cleft lip surgery is often performed within six months of birth, while cleft palate surgery is done around the baby's first birthday. Cleft palate and/or cleft lip anomalies occur in 1 in 700 births, or about 0.14 percent of babies.

The skull is made of separate bones that fuse after birth. Sutures between the skull bones allow for brain growth during fetal development. Craniosynostis is the early closure of cranial sutures before the brain is fully developed and occurs in about 1 out of every 2000 births. As the brain continues to grow, it creates pressure within the skull. The build-up of pressure within the cranium can result in irregularities in facial bone growth, sometimes including the eye orbitals and jawbones. Plastic surgeons can help to restore function and symmetry through reconstructive surgery.  

If there is a problem with the blood supply to the face of a fetus during the early stages of pregnancy, a condition called hemifacial microstomia can develop. Babies born with hemifacial microsomia have facial structures on one side of the face that are smaller or less developed than the other side of the face. Most cases involve the mouth, jaws, and ear, but sometimes the eye and cheek are affected. More rarely, areas on both sides of the face are may be underdeveloped. This condition is seen in about 1 in 4000 births. 

Ear anomalies occur in as many as 45 percent of births, although many cases do not need surgical treatment.  Ear surgery is normally performed when the child is more than 5 years old and may require multiple surgeries to achieve the best cosmetic results. Microtia is a condition where the external portion of the ear is underdeveloped. Sometimes a portion of the external ear is malformed or smaller than normal, and sometimes the entire ear is too small. Usually, it is only one ear that is affected, but about 1 in 5 cases of microtia involve both ears. Microtia occurs in about 1 in 7000 births.

If your child has been born with a craniofacial anomaly, or an anomaly has been seen in an ultrasound, contact a local plastic surgeon to learn what your next steps should be.  


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