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Vital Signs


Vital Signs

Summer 2011

Early Intervention and Teamwork Are Key to Helping Infants with Birth Defects


VS-Summer11-Birth DefectsThese anomalies — as well as other common birth defects that can also cause craniofacial anomalies — not only affect the way the child’s face looks but may also lead to problems with swallowing, speech, hearing and vision. UCLA experts say addressing the unique issues of children with craniofacial anomalies requires a multidisciplinary approach involving collaboration among many specialists.

“It’s all interrelated,” explains pediatrician and geneticist Katrina Dipple, M.D., Ph.D., co-director of the UCLA Craniofacial Clinic. Dr. Dipple says that other common birth defects include craniosynostosis, a condition in which an infant’s sutures (soft spots) close too early and cause the head to become misshapen and prevent normal brain and skull growth, and hemifacial microsomia, a condition in which the tissues on one side of the face are underdeveloped, affecting primarily the ear, mouth and jaw areas. Craniofacial defects may also occur after birth.

“If the clinicians treating children with craniofacial anomalies don’t pay careful attention to other developmental problems — such as speech impediments or hearing loss — in addition to the physical defects, these issues will persist until children have difficulties socializing or keeping up in school, among many other concerns,” Dr. Dipple says.

The team at the UCLA Craniofacial Clinic includes pediatricians, plastic surgeons, neurosurgeons, speech therapists, audiologists, dentists, orthodontists, ophthalmologists, otolaryngologists, geneticists and social workers. Patients can be seen by multiple specialists on one day, in one location, at the UCLA clinic. At the end of the clinic, these specialists meet to discuss and develop an individualized plan of care for each patient. The UCLA clinic also provides information, such as genetic counseling, and social support, including forums and activities through which affected patients and families can meet to discuss their unique challenges.

Among these challenges, says UCLA plastic surgeon Reza Jarrahy, M.D., are the multiple surgeries that children with craniofacial defects confront beginning as early as the first week of life and continuing through the late teenage years. “With early intervention, most of these children do very well,” says Dr. Jarrahy. The best outcomes result from early intervention and teamwork. “Patients should be referred as soon as a problem is identified or suspected,” he urges, emphasizing that delayed presentation can make some patients medically unqualified to receive these techniques.

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