>> There's challenges that I see in dealing with pediatric craniofacial anomalies. What
may be present today when I'm 4 years old is going to be different when I'm 7 and when
I'm 13 and 15. Not only am I growing and the inherent growth qualities of various parts
of the face are going to be different at those different ages, but also, things that are
happening in my life change. The doctor is going to treat each patient through to maturity.
Which I think is a really nice thing for families. You get to develop a really deep relationship
with each other.
>> So when a parent comes to CHOP with their child for a clinic visit, what they're going
to find on that day is every specialist that they could possibly need.
>> A lot of kids with craniofacial anomalies need braces, or potentially orthognathic surgery,
or jaw surgery, to get the teeth in the right place.
>> Any wigglers?
>> No, not lately.
>> We're not just looking at the teeth. We're not just looking at the surgical needs. But
we can communicate with each other to try to come up with what's going to be the best
plan for the patient as a whole.
One of the services we offer here is three-dimensional, surgical treatment planning and
surgical modeling. And we found that we were getting really excellent results.
>> Many of the patients who come through the craniofacial program also have conditions
relative to the eyes and the eye sockets. So we also have an ophthalmologist.
>> The eye doctor may look into the back of the eye and check for pressure. Or they may
check that the eye muscles line up appropriately.
>> All right pretty girl, can you hear me?
>> Yeah.
>> All right. So we're going to start with our words.
>> We also have an otolaryngologist.
>> Ice cream
>> Hot dog
>> A speech pathologist who is part of the team.
>> The speech pathologist's role is to determine if a difficulty is present, what the nature
of that difficulty is, to collaborate with the team so that we can develop treatments
for that child.
>> And then a psychologist who can help the patient and their family deal with some of
the psychosocial issues. What is it like to deal with pain? How do you talk to other kids
about your facial appearance?
>> We're dealing with kids and families in times of a lot of growth and
development, and transition. And we're introducing additional stressors like major reconstructive
surgeries, appearance differences, speech differences, things that really affect kids.
Coping and functioning at home and in school.
>> You're going to meet the growth specialist who's going to measure different parts of
the face and see if they're in proportion, or if they're asymmetric.
>> Our geneticists make sure that we're not missing an underlying genetic syndrome.
>> Nurse practitioners offer a unique addition by looking at the
patient in a very holistic sort of sense.
>> I can be a vital contact for that family to help
explain the process, clarify the process, or help just provide that comfort.
>> We are the first line responders, if you will, to patient concerns.
>> This type of team care, where they're seen by all these specialists
at one time, really makes their care more efficient because it's all in one place, but
also most comprehensive so that nothing is missed and they get the best care.
>> So what we do on team day is we sit down and project the patients' images on the screen,
and then we go around the table and talk about each one of those patients.
>> Each individual team member brings a unique set of skills that really allows us to see
the whole individual, the global picture.
>> And as a result of all of us talking together,
and the input from all of the different specialist...
>> We formulate an overall assessment and then put a cohesive plan together, which we
think is the best formula for success for that patient.