CLEFT AND CRANIOFACIAL SURGERY
Cleft lip, cleft palate and craniofacial surgery involve the
comprehensive treatment of children with congenital defects (birth
defects) affecting their mouth, face and sometimes skull. A cleft
is a "split" or "separation" which can occur anywhere in the body,
but in these children occurs at the lip, nose or along the roof of
the mouth. Craniofacial birth defects can be varied, but usually
involve some aspect of an abnormally shaped skull. Clefts of the
lip and palate are the most common congenital deformity of the
face, affecting approximately one in every six hundred births. We
do not know exactly why clefts occur but they do run in families to
some extent. They are more common in Asian children and less common
in African-American children.
As the child grows, many different parts of the face may be
influenced by a cleft or abnormally shaped skull. Therefore, care
of a cleft or craniofacial child involves a coordinated group of
professionals who follow these children from birth until the
completion of growth. That team consists of: plastic surgeons,
paediatricians, geneticists, dentists, orthodontists,
otolaryngologists, oral surgeons, speech therapists, audiologists,
social workers and sometimes neurosurgeons and
ophthalmologists.
  | Craniofacial Clinic Our Craniofacial Clinic provides complete care and treatment for
children with all types of craniofacial disorders. This
includes children with birth defects, deformity following trauma,
or craniofacial growth disorders. Our team brings together
health professionals from many different fields to ensure that
patients and their families receive the best care. The team
consists of plastic surgeons, dentists, ophthalmologists,
anaesthetists, geneticists, orthodontists, photographers,
orthotists (helmet remodelling), psychiatrists, social workers and
specially trained nursing staff, both in theatre and the wards.
Download Craniofacial Surgery Information booklet
or
Deformational Plagiocephaly pamphlet. |
| |
 | Cleft Lip and Palate Clinic Our Cleft Lip and Palate Clinic here at the Royal Children's
Hospital has a large and experienced group of specialists - plastic
surgeons, oral and maxillofacial surgeons, ENT (Ear, Nose and
Throat) surgeons, audiologists, paedodontists, orthodontists,
otolaryngologists, speech pathologists, social workers and nurses -
who combine to form the Cleft Lip and Palate Clinic.
Download Cleft Lip & Palate - Questions &
Answers booklet. |
HAND, MICROVASCULAR AND GENERAL
PAEDIATRIC PLASTIC SURGERY
Our Department participates in a multidisciplinary team to
reconstruct and rehabilitate patients with congenital hand and
upper-extremity anomalies - hand problems present at birth or as a
result of a trauma or infection involving the hand or upper limb.
Anomalies include cerebral palsy, syndactyly (webbed fingers) and
arthrogryposis (joint contractures). Other services provided by
this clinic are microvascular surgery and distraction lengthening.
Our General Paediatric Plastic Surgery service provides expertise
in the treatment of common congenital hand anomalies, vascular
birthmarks and malformations, paediatric burns, microsurgery and
general paediatric plastic surgical problems.
Hand Clinic
Our Hand Clinic has evolved to meet the needs of children
with upper limb disorders ranging from congenital anomalies,
injuries, burns, neurological conditions, such as brachial plexus
injuries and cerebral palsy, through to rare conditions.
These include inherited conditions such as epidermolysis bullosa,
rheumatological conditions and vascular anomalies.
The clinic is staffed by plastic surgeons, orthopaedic surgeons,
occupational therapists, physiotherapists, orthotists and nursing
staff all trained in the care of children with congenital and
acquired conditions of the upper limb.
 | Brachial Plexus Palsy Clinic Our Brachial Plexus Clinic is run by a multi-disciplinary team,
headed by
Bruce Johnstone. Your child will be seen by a physiotherapist
from the clinic on a monthly basis and regularly by the clinic
doctor throughout the first year of life. Surgery will be
recommended where appropriate. Children who have ongoing
problems or have been operated on are followed up by the
physiotherapist and occupational therapist until school age and
beyond. Download Understanding Brachial Plexus
Palsy booklet. |
 | Microtia Clinic Our Microtia Clinic was developed by the Department in
conjunction with the Department of Otolaryngology. This
specialist clinic enables a combined approach to treating patients
with Microtia (underdeveloped or no ear) and other complex ear
abnormalities. The clinic is staffed by plastic surgeons and
ear, nose and throat surgeons. For more information, visit
the Microtia Australia Support Group website.
Download Microtia
and Ear Anomalies booklet. |
 | Saliva Control Clinic Drooling can be seen as a manifestation of many
conditions. For example, approximately 10% of patients with
cerebral palsy suffer from drooling (sialorrhea). Drooling is
normal in very young infants and toddlers, but in intellectually
intact older children, it can have significant impact. Soiling of
clothes and surroundings can cause emotional isolation and even
physical problems with oral maceration and dehydration. Treatment options include a range of interventions. For some
patients, no treatment is an appropriate recommendation. Young
patients with no significant medical complications, good oral motor
skills, who may improve with further maturation, can be carefully
followed. Patients with a low cognitive level or significant
physical problems with a poor outlook for change may require other
interventions. For some patients in whom other interventions are
unsatisfactory, surgical intervention may be required. The most
common procedure for the control of sialorrhea involves rerouting
the ducts of the submandibular salivary glands to the tonsillar
fossa. This reroutes the majority of the salivary flow posteriorly
in the oral cavity allowing better control of sialorrhea through
swallowing. Download Saliva Control In
Children booklet. |
Vascular Anomalies Clinic
Our Vascular Anomalies Clinic headed by Anthony
Penington specialises in treatment of infants and children
with vascular lesions. Hemangiomas and vascular malformations can
be difficult to diagnose properly if one is not familiar with these
lesions. Up to 50-60% of these lesions are diagnosed incorrectly,
or are mistreated. While the uncomplicated hemangioma may be
watched expectantly until it begins to involute, early intervention
is often necessary and very beneficial for the more aggressive and
complex vascular lesions. Our clinic provides the expertise to
properly diagnose and recommend treatment and/or intervention for
these lesions.
General Paediatric Plastic Surgery
Our General Paediatric Plastic Surgery service provides
expertise in the treatment of common congenital hand anomalies,
vascular birthmarks and malformations, paediatric burns,
microsurgery and general paediatric plastic surgical problems.
Paediatric plastic surgeons provide treatment for the
following:
Birth defects of the ear (protruding or absent
ear)
Birth defects of the chest and limbs (misshapen breasts,
webbed fingers)
Injuries to the head, face, hands, arms, and legs
Birthmarks and scars
Burn reconstruction
Aesthetic surgery for deformities that may have psychological
implications
Vascular anomalies
Hemangiomas
Section Chief - Christopher J.
Coombs
ORAL AND MAXILLOFACIAL SURGERY
Oral and maxillofacial surgery is a specialty encompassing the
surgical and related treatment of diseases, injuries and
deformities involving both the functional and aesthetic aspects of
the head, face, mouth, teeth, gums, jaws, and neck. This
includes preventive, reconstructive, or emergency care for the
teeth, mouth, jaws, and facial structures.
The paediatric and adolescent oral and maxillofacial service at
the Royal Children's Hospital of Melbourne cares for children and
adolescents born with congenital, developmental and acquired oral
and facial deformities. The philosophy of our Section is to provide
the highest level of care as an integrated component of a team
approach.
Oral and Maxillofacial Clinic
Our oral and maxillofacial clinic cares for people with problem
wisdom teeth, facial pain, and misaligned jaws. Our surgeons
treat accident victims suffering facial injuries, offering
reconstructive and cosmetic solutions. They are concerned about
helping children born with poorly shaped jaws and they care for
patients with cancer. Their concern extends to their patients'
total health.
Section Chief - Andrew A. Heggie