A multidisciplinary team approach to craniofacial care

Advanced surgical technology now allows us to take our care to the next level.

Norton Children’s has offered families multiple surgical interventions to address complex craniofacial pathology for more than 30 years.

Paul Tessier, M.D., the father of craniofacial surgery, planted the seed by training surgeons who practiced in Louisville.

Advanced surgical technology and a new streamlined experience for families at Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, now allow us to take our care to the next level.

Powerful new software allows us to combine multiple scans into a single, dynamic 3D image, allowing for better preoperative planning and minimally invasive surgery. The technology allows for shorter operating times, meaning a lower risk of infection, and the potential for fewer blood transfusions and a shorter recovery time in the hospital.

The streamlined experience allows patients and their families to see a neurosurgeon and craniofacial surgeon on the same day, in the same room. This patient-centric focus will go a long way in reducing anxiety for parents and caregivers.

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The craniofacial disorders team at Norton Children’s Neuroscience Institute is a multidisciplinary group of specialists, including plastic surgeons; pediatric neurosurgeons; ear, nose and throat surgeons; critical care providers; pulmonologists; geneticists; and speech-language pathologists.

Our team has a range of training and subspecialization, allowing us to handle any congenital anomaly as well as intracranial, extracranial and vascular issues in infants, children and young adults. These include cleft lip and palate, craniosynostosis, craniofacial syndromes, ear anomalies, facial clefts, facial synostosis, orbital deformities, plagiocephaly and sleep apnea.

Our new neuroimaging lab allows for volumetric analysis, meaning we now are able to take the guesswork out of distraction osteogenesis in craniofacial surgery — when we make a longer bone out of a shorter one. This technology enables us to do it more precisely, allowing for greater movement and stability.

In the past, when remodeling the skull or calvarium for patients with craniosynostosis, the surgeon often had to estimate the amount of overexpansion required to account for the quickly growing brain. Now we are able to forecast brain volumetrics much more accurately to customize the outcome to each individual patient.

We’ve also used pre- and post-surgery imaging to critically evaluate our technology, conducting clinical research and submitting our work to peer-reviewed journals. Scott Rapp, M.D., director, craniofacial surgery, and attending pediatric plastic surgeon, Norton Children’s Hospital, and colleagues recently published a paper in the Journal of Craniofacial Surgery, “Three-Dimensional  Volumetric Changes in Posterior Vault Distraction With Distraction Osteogenesis.”

In addition to Dr. Rapp and pediatric plastic surgeon Mark Chariker, M.D., the paper’s authors included Ian S. Mutchnick, M.D.; William C. Gump, M.D.; and Thomas M. Moriarty, M.D., Ph.D.; of Norton Children’s Neuroscience Institute.

Even as we embrace the latest technology, we never lose sight of our primary goal: providing patients and their families with exceptional care. A craniofacial multidisciplinary clinic will be opening soon.


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