Helping children lead healthy lives has always been a key mission of Winthrop-University Hospital. Now, thanks to a partnership between Winthrop's Department of Pediatrics, the Division of Plastic and Reconstructive Surgery and the Department of Neurosurgery, children diagnosed with craniofacial deformities in infancy are leading happy, healthy, normal lives.
Dr. Burt Greenberg, Division of Plastic and Reconstructive Surgery (right) and Dr. Steven Schneider, pediatric neurosurgeon (left) before surgery.
What are Craniofacial Deformities?
Burt Greenberg, MD, Division of Plastic and Reconstructive Surgery at Winthrop, explained that an infant's skull is comprised of multiple bones that fit together like pieces of a jigsaw puzzle. In infancy, these bones are separated by sutures that allow the skull to expand and grow as the infant's brain develops and triples in volume during the first year of life. If one or more of these sutures prematurely fuse, craniosynostosis results.
Craniosynostosis causes an abnormal head shape. Depending on which section of bone is fused together, the skull grows in different directions as the brain develops, causing the infant's head, in some cases, to become pointed or the forehead to protrude. If suture fusion exists, surgery is warranted.
Diagram of the five sutures of an infant's skull. When one or more of these sutures are fused, craniosynostosis results.
Winthrop has become one of the few established centers on Long Island for craniofacial surgeries in infants, and the success of these surgeries has been tremendous.
Just ask Jennifer Rieger whose 11-month old daughter, Alyssa, underwent a successful surgery in January 2004 at Winthrop to correct her skull abnormality.
When Alyssa was two months old, her parents noticed that something was a little "off" about their beautiful little girl. It was around this time that Mrs. Rieger observed that the infant's head was a bit misshapen and addressed this concern with her pediatrician.
Alyssa was initially diagnosed with positional plagiocephaly because of a noticeable indentation on the backside of her head. Plagiocephaly, a flat spot caused by repeated external pressure applied to the same area of the skull, is commonly seen in infants who are placed on their backs to sleep.
After extensive research on craniofacial deformities, Mrs. Rieger was referred to Dr. Greenberg.
CT scans were performed on the infant, which showed (segmental) fusion of the right lambdoidal suture (see diagram), an indication of craniosynostosis. In advance of surgery, Alyssa was fitted with a molded orthotic helmet in an effort to correct the abnormal shape of her head. When no change was apparent, the team of Dr. Burt Greenberg and Dr. Steven Schneider, Pediatric Neurosurgeon at Winthrop, as well as Alyssa's parents, agreed that surgery was the best option.
"In my heart of hearts I knew this was what needed to be done," said Mrs. Rieger. "Although it was a very difficult and emotional decision, we agreed with the doctors that moving forward with the surgery was the right choice."
Alyssa Rieger before surgery with flat spot on backside of head (see arrow) Notice the misalignment of the ears due to the condition.
Alyssa several days after successful surgery. Her head shape is now rounded with room for the brain to grow.
"Craniosynostosis can restrict brain growth and has been linked to neurological defects and learning disabilities," explained Dr. Greenberg. "It is important that the condition be recognized and treated early in an infant's life."
He recommends that reconstructive surgery be performed between three and nine months of age, when the bones of the infant's skull are most malleable.
The procedure involves the surgical reconstruction of the abnormally positioned cranial bones and suture release to allow for proper skull growth.
"Surgical intervention is necessary when there is premature closure of sutures resulting in severe deformity and/or compression in the brain," stated Dr. Schneider, who has been working with Dr. Greenberg for almost 15 years. "Not only does surgery improve the skull aesthetically, but provides more space for the brain to grow."
According to Warren Rosenfeld, MD, Chairman of the Department of Pediatrics at Winthrop, "We are extremely proud that Winthrop has a team of dedicated professionals who are committed to helping improve the lives of these children."
Winthrop's experts in the Department of Neurosurgery, including Dr. Alan Rosenthal, Co-Director of the Institute for Neurosciences at Winthrop, have also been advocates for children with craniofacial deformities, helping to further advance the highly sophisticated procedure.
At home and recovering nicely after her surgery, Alyssa is still the same sweet baby who enjoys playing with her older sister and whose smile is certainly contagious. To date, the surgery has been a success as her head is beautifully rounded with room for the brain to develop and no flat spot.
"The doctors said Alyssa was a model patient and we couldn't have been happier with the wonderful care we received from everyone at Winthrop during a very emotional time for our family," said Mrs. Rieger.
She added, "We truly believe that everything will be better for Alyssa with the surgery. She won't have to live with the disfiguration or any potential health problems that may have been caused by her condition. We just want Alyssa to live a normal life. Without the surgery, I don't think she would have been able to."
For more information on craniofacial surgery at Winthrop-University Hospital, call 1-866-WINTHROP.