Conditions We Treat

Every year at the Cleft-Craniofacial Center, we see hundreds of children with craniofacial disorders. While some of these disorders were acquired through trauma or injury, most are congenital, meaning that children were "born" with these diagnoses. Rest assured, though we realize that this is all scary and new for you and your family, we have seen children with your childs problems before! In fact, one of the great things about our craniofacial team is that we encourage parents of new patients to talk to the parents of our current and older patients! We know that as parents, the stress and anxiety of making a life-changing decision for your child can, at times, be overwhelming. We try to guide you through the process with the same care and attention that we would give our children. Our comprehensive team approach is widely regarded as best in the state.

Staff at the Craniofacial Center at Goryeb Children's Hospital includes experts trained in:

  • Developmental pediatricians
  • Genetics and maternal-fetal medicine
  • Oral and maxillofacial surgery
  • Pediatric dentistry
  • Pediatric gastroenterology
  • Pediatric general surgery
  • Pediatric neurology
  • Pediatric neurosurgery
  • Pediatric nursing
  • Pediatric ophthalmology
  • Pediatric otolaryngology
  • Pediatric orthodontics
  • Pediatric orthotics
  • Pediatric physical therapy
  • Pediatric plastic and reconstructive surgery
  • Pediatric psychology and neuropsychology
  • Pediatric pulmonology
  • Pediatric social work
  • Pediatric speech pathology and swallowing
  • Pediatric urology

Please read through our glossary of terms, to become familiar with many of the conditions and syndromes that we have successfully treated here at the Goryeb Craniofacial Center.

Cranial Disorders

Craniofacial disorders can be congenital or acquired. They can be limited to the skull vault (above the eyes and ears), the skull base (at the level of the eyes and ears), or the face. The skull vault, base and face may be involved in a mild fashion, or they may be severely affected. Whatever the case may be, we have taken care of newborns, infants and children with the most severe craniofacial disorders, and many of themif you saw them on the streetwould not know that they ever had surgery.

The skull vault disorders involve the bones and sutures of the skull. Positional deformity of the skull, called plagiocephaly, may be mild or severe. Plagiocephaly is usually treated with an orthotic called a cranial helmet or "molding helmet". The helmet or orthotic device is worn 23 hours a day for 2 - 12 months depending on the severity of skull deformity. Craniosynostosis, or the fusion of the sutures of the skull, does require a surgical repair. (Please see our web page on Cranial Repair). There is open or endoscopic repair procedures available for craniosynostosis. Our team is the first in the state to have pioneered endoscopic or minimally invasive craniosynostosis repair.

Skull tumors may be benign or malignant, but almost all are surgically removable and curable. There are vascular malformations of the bones of the skull, but most children with vascular malformations that we see at our Craniofacial Center have scalp or facial hemangiomas. Some are treated with oral medicines, and some involute (shrink) by themselves over time. Rarely, do these lesions ever need to be surgically removed or embolized (glued closed). We have treated children with complicated orbital hemangiomas, and they have done quite well.

Our Craniofacial Team has special expertise in the repair of craniofacial trauma. As a Level I Trauma Center, Morristown sees its share of patients with complex craniofacial trauma. For children we often try to use absorbable hardware and instrumentation, so that there are no permanent mini-plates or screws used.

Facial Disorders

Children are sometimes born with birth defects, anomalies or disorders that affect the cosmetic appearance of their face and may actually interfere with breathing and/ or swallowing. Some disorders are obvious at birth, while other disorders may be subtle or appear after birth. The Craniofacial Team at Goryeb has cared for babies not yet born; we do see parents of fetuses who have cleft lip and/ or cleft palate. We do provide prenatal consultation and education for parents of these infants. Once the babies are born, our surgical team will assess the defect and determine the proper steps to repair. Our speech and swallowing experts will teach you as parents how to feed or nurse your baby. We have a whole team approach to caring for infants with cleft lip and cleft palate. We set the true standard for care in the state.

Babies born with Pierre Robin, isolated micrognathia or airway obstruction are seen in the nursery by our pediatric ENT specialist, pediatric pulmonologists and feeding specialists. The babies are cared for here at the Goryeb Childrens Hospital until stable and clear for discharge. Once the infant is clear for discharge, we provide careful follow up and support for the parents and family. Babies are then brought back to Craniofacial Team for regular follow-up.

Hemifacial microsomia may be seen alone, or as part of Goldenhar syndrome. Often, children do not require surgery at all, but those that do require preparative steps offered at our center that lead up to a successful surgery. Teenagers who require facial surgery truly benefit from our pediatric psychologists support and counseling as surgery is discussed and planned.

There are hundreds of facial disorders, and yes, we have seen them all. We can provide you and your family with innovative, cross-disciplinary care that ensures a successful outcome and positive overall experience with our handpicked team of professionals.