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Pediatric Specialists Offer Multidisciplinary Approach to Repairing Craniofacial Abnormalities
Two surgeons who specialize in pediatric care work within the craniofacial team at University of Missouri Health Care’s Children’s Hospital to repair childhood skull deformities. Arshad Muzaffar, M.D., associate professor in the Division of Plastic Surgery and director of craniofacial and pediatric plastic surgery at the University of Missouri-Columbia School of Medicine, and Usiakimi Igbaseimokumo, M.D., assistant professor in the Division of Neurological Surgery at the MU School of Medicine, are part of a team of surgeons, nurses and other health care providers who offer a specialized approach to treating children with craniosynostosis. The normal cranial structure of a child consists of five plates of bone that are separated by sutures. These sutures are flexible, fibrous joints that are found between the bony plates of the skull. As an infant grows and develops normally, the sutures will eventually close and permanently shape the skull. “Craniosynostosis is the premature fusion of one or more of the cranial joints,” said Muzaffar. “In children, these fibrous sutures must be flexible so that the brain and skull can develop normally. When the sutures are prematurely fused, the result is an abnormally shaped head that will not only present cosmetic issues but can also be the cause of developmental problems.” Craniosynostosis occurs in approximately one out of every 2,000 live births and affects males twice as often as females. Symptoms often include a noticeably misshaped head, increased irritability, poor feeding and developmental delays. The condition is diagnosed through physical examination and diagnostic tests such as computerized tomography, or CAT scan. Surgery to remodel the skull is usually the recommended treatment. The goal is to reduce the pressure in the head and correct the deformities of the face and skull bones. “The optimal time to perform surgery is before the child is one year of age since the bones are still very soft and easy to work with,” said Igbaseimokumo. “The procedure includes an incision across the top of the skull to expose the cranial plates. Once exposed, we are able to remove the top portion of the skull and reshape it with absorbable plates and screws.” The procedure usually lasts from three to six hours and parents can expect their child to spend one to two days in the pediatric intensive care unit and usually two to three more days in Children’s Hospital for observation purposes. “The most common thing parents report after corrective surgery is that the symptoms of craniosynostosis are gone,” said Igbaseimokumo. “Of course the configuration of the skull has changed to a more normal shape, but other effects are that the child is no longer irritable, the child feeds better and behavior associated with headache or pain goes away.” Coordinated care by a craniofacial team comprised of professionals from a variety of health care disciplines is important so that treatment goals can be customized for each child and parents and health care providers can make the best choices by consulting with each other. “Our program includes not only the pediatric plastic surgeon and pediatric neurosurgeon, with additional specialized training in craniofacial surgery, but other sub-specialists such as a pediatrician, a geneticist, an orthodontist, a speech pathologist, an otolaryngologist, an audiologist, a social worker and an ophthalmologist, among other specialists, so that we can work together on specific treatment plans for each child,” said Muzaffar. For Muzaffar and Igbaseimokumo, accessibility is also an important aspect of the quality of their program. “Access to our program is a key issue, so we make it a priority to see new patients within a day or two,” said Muzaffar. “It’s critical for referring doctors and for the parents to be able to see us as quickly as possible. My vision is to make our pediatric craniofacial program the leading program in the region.” For more information on the MU Children’s Hospital’s craniofacial program, please contact Lynette Baker, R.N., pediatric plastic surgery coordinator, at (573) 882-4176, Cathy Cartwright, R.N., M.S.N, pediatric clinical nurse specialist, at (573) 882-3424 or visit the program website. Children’s Hospital facility is the largest and most comprehensive pediatric health-care center in mid-Missouri. Housed at University Hospital and Clinics and Columbia Regional Hospital, the 115-bed hospital is the only facility in mid-Missouri offering comprehensive, specialized children’s services such as trauma care, neonatal transport, child life therapy and a hospital school. |
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