When a child has a facial difference, there is often a great deal of concern about the many challenges that will have to be addressed. Sometimes the most difficult challenge will be finding comprehensive, quality treatment. National Acceptance Month is sponsored by the Children’s Craniofacial Association.
John Canady, MD, facial plastic surgeon at UI Children’s Hospital, located at UI Hospitals and Clinics, talks about the treatment for children with craniofacial disorders:
When we talk about craniofacial disorders, what does that include?
It’s any abnormalities or changes that have to do with the head and neck, so it can include the face, the soft tissue of the face, the skin, or the bones of the face; it can include the soft tissue of the scalp or the bones of the skull. They can either occur because of a problem that was present at birth—that’s called congenital—or they can be acquired sometimes by trauma or accidents, things like that.
How early in an infant’s life should they be assessed if born with a facial abnormality?
Most things would benefit from an assessment as early as possible. Many times, besides what’s apparent, other things may be going on that are discovered as part of the examination. It’s our preference to see kids as early as they can reasonably come to our team and our clinic in Iowa City to get their evaluation done.
How important is it for an infant with a facial abnormality to be seen by a pediatric plastic surgeon?
It’s important that they be seen by somebody who’s comfortable and experienced in the condition that they have, but beyond that, it’s important that they be seen because a lot of times, like I said, there’s many things going on and there may be other issues that come up that need to be treated by other specialists. Here we have a team comprised of specialists from all over the University and we can use that expertise, and that makes a very good situation for the patients we treat.
Are facial abnormalities something that are repaired in one surgical procedure?
Some can be; others need to have more than one surgery because—particularly when you’re dealing with kids—you have to deal with the fact that they’re continually growing until they reach their teenage years. So a lot of times the initial correction is done and then may need to be touched up as time goes by.
In general how many procedures over what period of time in a child’s life are needed to fully repair their face?
It’s a very individual thing because it really depends on what abnormality or problem they come with in the first place. And then, to some extent, on how they heal after each surgical procedure is done.
Aside from physical appearance, why is it important to correct facial differences?
A lot of them have functional implications, as well. So it may be that chewing isn’t as easily done as it might be, it may be that speech is a problem, a lot of different things. So it’s not all just about the appearance of craniofacial problems. It’s about correcting some of the functional problems, or as many of the functional problems as can be corrected, as the overall goal of the treatment.
What issues do children who are born with or acquire facial abnormalities deal with among their peers?
Well, kids can be tough. Everybody that’s been through school, I think, has been teased about something. Kids that have craniofacial differences can sometimes be singled out and teased even to a greater extent than just whatever “normal” teasing is. So it’s important that these kids feel that they have a support mechanism to deal with this sort of peer interaction.
Who is all included in the team that makes up the Cleft Palate and Craniofacial Center at UI Children’s Hospital?
Boy, I’m sure I’ll forget somebody as I run through the list because it’s extensive. But we have pediatric dentists, orthodontists, speech therapists, audiologists, pediatrics otolaryngologists (ear, nose, and throat doctors), pediatric neurosurgeons, pediatric ophthalmologists, pediatric anesthesiologists; I’m a pediatric plastic surgeon. So there really are a number of people here that spend almost the majority of their practice taking care of kids exclusively, and I think that’s a real strength of our team and the Children’s Hospital in general.
Why is it important that the family works with the entire team with regard to their child and his or her acceptance in their community?
I think that what the team brings is the breadth and depth of experience to really handle virtually any problem that walks through the door. The scope of some of the things that kids come here with is so extensive that no one individual person really has the training or background to take care of the entirety of the problem. But by relying on different members of the team, we’re able to effectively cover whatever the problems are that come in.
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