MDNews - Minnesota

COV ER+ FE AT UR E orthotic helmet, then reshape and revise it every two weeks. Treatment usually requires two to three months, which is often shorter than the time needed for other types of helmet therapies. "We have treated 7,000 children with the Gillette CranioCap orthosis, and our patient satisfaction scores are outstand- ing," Dr. Wood says. "Children grow rapidly during the time of treatment, and continually revising the helmets to encour- age appropriate head growth is critical to success. Gillette's commitment to superior outcomes is reflected in the fact that we have a significant number of orthotists dedicated to the CranioCap program, and each of them has handled 600 cases or more. I attribute our success to their expertise." Approximately 50 percent of children who have plagiocephaly also develop torticollis, which causes abnormal head posture. Gillette's physical therapists resolve 95 percent of torticollis issues through therapy alone; the remaining 5 percent of cases are addressed through surgery. Moebius Syndrome Moebius syndrome is a rare birth deformity in which children are born without facial nerves. As a result, they are unable to show facial expressions. Because the condition is seldom seen, and because there are few surgeons with the pediatric microsurgical expertise needed to address the condition, many pediatricians may not be aware that treatment is available for these children. "The facial nerves enable us to animate our faces and show expression," Dr. Lim says. "Children with Moebius syndrome are often discounted from an intellectual standpoint, disciplined or considered insolent because they can't emote. We are surgically able to animate their faces by taking smaller muscles from the thighs, disconnecting the blood vessels and nerves, and reconnecting them to other nerves in the face using microsurgical techniques to sew together blood vessels between 1 and 5 millimeters in diameter. This is a difficult surgery in pediatric patients because the vessels are so small, but the surgery gives these children the ability to smile when they feel happy. It's quite astounding." Research Initiatives and Medical Advances Gillette's clinical research is informed by an extensive outcome database. "We are able to capture data from the thousands of patients we treat on an ongoing basis, with fields for all of the dif- ferent subspecialties involved in treating these patients," Cordero explains. "The database was designed to be compatible with developing projects like Americleft, a national initiative with the goal of facilitat- ing outcome comparisons at centers across the country. That data will help increase transparency in care." Cordero is also enthusiastic about new technology to inform surgical decisions and improve speech outcomes for patients. "Developing instrumentation can mea- sure palate deformities more accurately than was possible before," she says. "Gillette is the only site in this area offering a precise form of aerodynamic pressure-flow testing to calculate the gap size in the velopharynx. When pediatricians have concerns related to a child's speech, or when nasality or another speech issue seems to be related to structure — such as a bifid uvula — or to tonsils or adenoids, we have the resources to evaluate that child and the expertise to deliver treatment that will maximize speech outcome." As Gillette hones its resources and exper- tise, the craniofacial team looks forward to each patient's first day of school. "We want these children to go off to school and be unrecognizable to their peers as having had corrective surgery," Dr. Wood says. "The compelling thing about cranio- facial repairs such as cleft lip and palate is that laypeople can look at before and after photos and judge the quality of a repair for themselves." Dr. Lim's professional experience includes three years providing cleft lip and palate repairs in Ethiopia. "I think cleft lip repair is the most inspiring operation I do," he says. "When this condition is not treated effectively, the results are devastating. Yet, with the right resources, a fairly brief operation can completely transform these children. It's as though the cleft never happened. I really love that." Physicians and health providers can reach one of the Gillette specialists or make a patient appointment by calling Gillette's one-call access number at 651-325-2200 or 800-325-2200. More information can be found at www.gillettechildrens.org. ■ Gillette developed the FDA-approved CranioCap to treat infants with deformational plagiocephaly. 8 | Minnesota MD NEWS ■ M D N E W S . CO M

• Cover