The Cleft and Craniofacial Center at Cincinnati Children’s conducts basic and clinical research into the causes and treatment of congenital craniofacial malformations. Learn more about our basic science and clinical research that is changing the way physicians care for children with craniofacial malformations.
Tissue Engineering of Bone and Cartilage
A research team is on the cutting edge of finding a way to grow better bone and cartilage, two critical components of reconstructive surgery for craniofacial bony defects.
Critical defects of the craniomaxillofacial region, as well as long bones, are often treated with vascularized osteocutaneous free flaps. These are lengthy operations, may be associated with considerable donor site morbidity, and often have suboptimal functional and aesthetic results. Tissue-engineered vascularized bone and cartilage offer an attractive alternative. Using a combination of adult mesenchymal stem cells, growth factors, cadaver bone and vascularized periosteum, we have engineered vascularized bone and cartilage flaps that can be used to aid in facial reconstructions. This will allow us to offer better, more effective, less morbid procedures to our patients.
Composite Tissue Allotransplantation, Also Known as Facial Transplants
Facial transplantation, once a dream, is quickly becoming a reality. Cincinnati Children’s is on the forefront of research efforts to make this promising treatment safer through the development of improved surgical techniques and immunologic tolerance. Our novel flap for facial and scalp transplantation received a warm reception at the American Society of Reconstructive Microsurgery’s annual meeting. Our unique strategies to induce immunological tolerance provide unique insights into how humans identify self versus foreign material. It is our hope that we can translate our laboratory efforts into the clinical setting in the near future.
Clinical Study on Usefulness and Reliability of Wideband Reflectance
A large clinical study is under way to evaluate the usefulness and reliability of wideband reflectance, a new technique that could help us determine the health of a child’s middle ear. We are studying two groups of children between 3 months and 18 years of age: Group 1 is children with normal hearing and without ear infections or other ear diseases, and Group 2 consists of children with active middle ear disease. This study will use wideband reflectance to establish a baseline of normal middle ear function in children.
The epidemic of positional plagiocephaly, or “flat head,” has significantly increased since the American Academy of Pediatrics issued the “Back to Sleep” campaign to reduce the incidence of SIDS in newborns. An effective treatment is the use of a molding helmet. The research study will use 3-D imaging to compare cranial asymmetry and head growth before and after completion of helmet therapy.
Minimally Invasive Craniofacial Surgery
Christopher Gordon, MD, is a pioneer in the new field of minimally invasive craniofacial surgery. The field promises to achieve the same, or better, results with less risk than traditional surgical techniques. Gordon has developed techniques to perform most craniofacial osteotomies, including those in which distraction osteogenesis is employed, through minimally invasive means.
Nasoalveolar Molding (NAM) and Pre-Surgical Orthopaedics
Nasoalveolar molding (NAM) is a combination of a palatal device that moves the baby’s gums into better dental alignment and a nasal mold that reshapes the nostrils. Our team provides an individualized evaluation of each infant so that the best combination of palatal device and / or nasal molds is implemented.
The palatal device that we use is also known as a pre-surgical orthopedic appliance. It is similar to an orthodontic appliance and is surgically pinned into the palate by the pediatric dentist. The baby wears the appliance 24 hours a day for about six weeks. Babies are seen by the pediatric dentist once a week to check and adjust the appliance, and parents are instructed in turning the screw that allows active movement of the appliance.
After six weeks, the palatal segments (gums) along with the cleft lip are in better alignment for surgical closure. The device is removed at the time of the cleft lip repair.
The nasal molds are customized to the degree of severity of the nasal deformity. We offer several approaches for improving the nasal shape.