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Techniques & Surgical Procedures

The staff at Children's Hospital & Medical Center Craniofacial Clinic uses some of the most advanced techniques and technologies to ensure your child receives the most effective treatment for their condition. Many of these procedures are not available anywhere else in the region. Some of these innovative procedures include:

Minimally invasive internal craniofacial distraction

Internal craniofacial distraction is a minimally invasive procedure that is safer and less invasive to treat certain types of facial deformities. The procedure involves implanting pins into the bone that are gradually moved apart. This allows new bone formation to occur in the gap by a process call distraction osteogenesis.

Bioresorbable devices

Bioresorbable devices may be used in many craniofacial surgery skeletal repairs and reconstructions. These devices can be easily contoured and fixated resulting in newer and quicker techniques that can improve your child's appearance. After the bone has healed, the devices dissolve in the body and leave no trace. Made out of polymers that are native to the body, these devices are free of harmful effects.

Nasal alveolar molding

Nasal alveolar molding is a procedure used to guide the growth of the mouth in the right direction prior to surgery to repair a cleft lip. Usually performed during the first two weeks of a baby's life, the entire process can last up to six months.

The procedure begins by inserting a custom-fitted denture into your baby's mouth. Adjustments to this molding plate are made each week to gradually reshape the roof of the mouth and gum lines. The plate causes the bones of the upper jaw to grow toward each other rather than to grow farther apart. It also provides a barrier between the mouth and nose, which are open to each other in babies with cleft lip and palate.

The next step involves placing a nasal extension into the palate that lifts the nose and nasal cartilages into place. This technique is especially important for children with bilateral clefts of the lip and palate. Effective application of this technique improves the initial surgical results and may minimize the need for later follow-up surgery.

Ear reconstruction

Our craniofacial team offers two types of ear reconstruction. Our team will help you determine which method is the best choice for your child.

Antologous ear reconstruction

Autologous ear reconstruction involves the use of your child's own cartilage and skin grafts to make the ear appear "normal." While it can help correct an ear deformity, the procedure will not repair the hearing in the deformed ear.

During the first stage of the procedure, cartilage is removed from the lower ribs of the opposite side of the body. The rib cartilage is carved to resemble an external ear, which is then placed under the skin of the affected side. In the second stage, the ear lobe is rotated into position. In the third stage, the ear is raised away from the head. A skin graft is then take from the top of the thigh or buttock to cover the back part of the ear.

Synthetic ear reconstruction

Ear reconstruction can be performed by replacing the ear cartilage with a synthetic material that allows incorporation of the implant by natural tissue in-growth. Naturally derived or synthetic materials can be formed into frameworks that provide a structure that allows the body's own cells to grow and form new tissues. The body gradually grows tissue into the synthetic implant and "incorporates" into it.

Laser treatment of hemangiomas

Hemangiomas are strawberry-colored "birthmarks" that vary in size and number. Hemangiomas are not true birthmarks as most appear in infancy and then begin to grow. During the first six months of life, 5 to 10 percent of hemangiomas ulcerate during their rapid growth phase, are painful, may bleed and are at risk for bacterial infection.

Traditional treatment of hemangiomas includes daily wound care, topical antibiotics and local or systemic steroids while monitoring its growth over a period of weeks, months or years. The majority of these skin lesions will gradually disappear by the time your child reaches seven years of age.

Laser treatment may be considered in cases in which the hemangioma ulcerates, does not appear to be regressing or if the lesion progresses toward disfigurement. Laser treatment can expedite healing and reduce pain within few days, often after a single laser treatment. Lesions generally heal in one to five weeks after treatment.

If hemangiomas are in problematic areas (around the eyes) or in a cosmetically sensitive area, your surgeon may recommend surgical excision to address the issue.

© Children's Hospital & Medical Center | In Affiliation with University of Nebraska Medical Center College of Medicine