A craniofacial disorder refers to an abnormality of the face and/or the head. Craniofacial conditions include disfigurement brought about by birth defect, disease, or trauma. John Canady, MD, a plastic and reconstructive surgeon in the Department of Otolaryngology—Head and Neck Surgery at University of Iowa Hospitals and Clinics, talks about craniofacial conditions and treatment:
How often does cleft lip and palate occur?
It occurs roughly one in 1,000 births. It varies a little bit around the world in relationship to race and geography.
What does a cleft lip and/or cleft palate look like in a newborn?
It's a gap. It's a failure of closure of the lip or the roof of the mouth. It really is a hole where the tissues just didn't come together when the baby was being formed.
How are cleft lip and/or palate treated?
Initially, it requires surgery because those tissues have to be brought together. It's more than just the skin, there are muscles involved and the lining tissue. Later, as the child gets older, there are other issues sometimes that have to be dealt with that involve the teeth, or speech, or hearing. A lot of different things may need to be done.
What causes the cleft lip and palate?
We don't fully know that yet. It's probably a combination of some genetic predisposition—but it's not purely genetic—as well as some environmental factors coming together. Some places in the world with a higher incidence of cleft lip and palate—there's active research going on looking at dietary influences on that.
How are those conditions treated long-term?
It is a long-term process because as a child grows and their face matures, things change a lot. Number one, it gets a lot bigger and they acquire different skills, they acquire language. It's a commitment to follow the children basically all the way through high school. Different things are done at different times on an individual basis for kids because everybody comes in as an individual and deserves to be treated that way.
Can craniofacial disorders affect mental capabilities?
Sometimes in certain combinations of things, and in certain syndromes—and a sydrome is just a grouping of findings that are found together. The vast majority of these kids are of normal intelligence. A very important point is that sometimes society looks at people who look different or talk a little bit different as maybe not being quite as smart. We spend a long time in reconstructive endeavors to get both form and function as good as possible because society judges people—sometimes unfairly—on how they look and how they talk.
Does an abnormal face or head affect physical capabilities?
Again, in some circumstances if a craniofacial condition is very severe or very involved, there can be physical capabilities that aren't what we wish they were. Having said that, in a lot of the kids I take care of, I've watched them grow up and I've had Division 1 athletes, I've had people in the theatre, I've had people really be successful in any way you can measure success, and that's one of the most gratifying parts of this business.
What is your best advice on how a person with a craniofacial disorder would like to be approached and treated?
They should seek out people who can deal with any sort of problem they may come up with. The head and neck area obviously is a very busy area structurally and functionally. No one person has the training or knowledge to completely treat a child with a craniofacial abnormality. That's why the majority of these kids around the country—and around the world where the services are available—are treated by teams of medical professionals. |
