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The Cleft & Craniofacial Program at Vanderbilt:
Multi-Disciplinary Team & Craniofacial Distraction
Michael Golinko MD FAAP FACS
Chief of Pediatric Plastic Surgery
Director: Cleft & Craniofacial Program
ISPAN 2019
Vanderbilt University Medical Center
Disclosures
Vanderbilt University Medical Center
All patient families and patients
have photographic consent
The Vanderbilt Cleft & Craniofacial Team
at Monroe Carrel Jr. Children’s Hospital “Operate, innovate, educate”
October 2019
Dr Brinkley Sandvall
Pediatric hand,
microsurgery,
Facial re-animation
General Peds Plastics
Dr Blair Summit & Stephane Braun
Laser & Fetal surgery, Cleft surgery Dr Golinko & Kelly
Craniofacial , Cleft & Jaw surgery
Clare Gargaro PA Amanda Bailey NPVanderbilt University Medical Center
Plastic Surgery
Neurosurgery
EN
T
Oral Maxillofacial
Jim Phillips MDSam McKenna MD, DDSStephane Braun MD
From “pre-natal to
Prom”
Twice Monthly
CME 1.0 credits ‘round-
table conference
immediately following
Surgery
Speech & Audio
Genetics
Dentistry
Social Work
The Vanderbilt Cleft & Craniofacial Team
Vanderbilt University Medical Center
Who & When to refer to Team
Any new patient of any age
that is new to Nashville with a
Cleft
Newborn primary cleft lip and
palate
Newborn ear deformities
Pierre Robin sequence as soon
as diagnosed
As son as clinical suspicion
raised
Craniofacial Microsomia
Treacher-Collins
Complex Craniosynostosis,
Apert, Pfeiffer, Crouzon
Vanderbilt University Medical Center
Clare Gargaro PA-C
HOW to refer
https://www.childrenshospitalvanderbilt.org
/program/cleft-craniofacial
Vanderbilt University Medical Center
3 month post-op
Cleft Lip & Palate 1 in 500-1000 births, most common facial birth difference
Vanderbilt University Medical Center
1.5 year follow-up
3 year follow-up
Craniosynostosis 1/1000-2000 births
Vanderbilt University Medical Center
Vanderbilt University Medical Center
Vanderbilt University Medical Center
Distraction
osteogenesis
Vanderbilt University Medical Center
Skeletal Distraction
Day 1 : Placement of device , then latency
Day 2-5: Device Activation, then consolidation
Days 60-90: Device removal
Vanderbilt University Medical Center
Vanderbilt University Medical Center
Pierre-Robin Sequence:
micrognathia glossoptosis cleft palate ( 1 in 9K-
14K)
Vanderbilt University Medical Center
Obstructive sleep apnea
Vanderbilt University Medical Center
Skull base – Matthews Device
Vanderbilt University Medical Center
Vanderbilt University Medical Center
Vanderbilt University Medical Center
Vanderbilt University Medical Center
LeFort I level
Vanderbilt University Medical Center
Cranial Vault Distraction to
expand intra-cranial volume
Vanderbilt University Medical Center
Vanderbilt University Medical Center
Vanderbilt University Medical Center
LeFort III Level- Crouzon
Vanderbilt University Medical Center
Vanderbilt University Medical Center
Hemi-facial or
Craniofacial
microsomia
Vanderbilt University Medical Center
Trauma
Vanderbilt University Medical Center
Gunshot to the face-initial CT
Vanderbilt University Medical Center
Vanderbilt University Medical Center
ORIF mandible + DBX/BMP bone
graft 8mm gap
Vanderbilt University Medical Center
Vanderbilt University Medical Center
Vanderbilt University Medical Center
Severe MicrognathiaSevere Micrognathia
Vanderbilt University Medical Center
Vanderbilt University Medical Center
Vanderbilt University Medical Center
Plastic Surgery
Neurosurgery
EN
T
Oral Maxillofacial
Jim Phillips MDSam McKenna MD, DDSStephane Braun MD
THANK YOU
Vandy NP team
Dora, Erin &
Amanda !
The Vanderbilt Cleft & Craniofacial Team
“Helping children face the world”
Vanderbilt University Medical Center