CME

Saving Face

Posted on Aug 30, 2017


The birth of a child represents one of the most precious and memorable events of a parent’s life.

When a baby is diagnosed with a cleft lip or cleft palate, one of the most common birth defects in the United States, the reassurance of a clear treatment plan can ease a parent’s mind.

“I want to make sure parents know what to expect,” explains Alex Rottgers, M.D., cleft/craniofacial surgeon at Johns Hopkins All Children’s Hospital. “I want them to know their child can live a normal, happy, and successful life.  Proper cleft care is a process that requires the help of many specialists, but we have an experienced team to help support their child and family every step of the way.” 

Camden, a patient of Rottgers, was born with a bilateral cleft lip and cleft palate.  Like many of Rottgers’ patients, Camden’s cleft lip was identified before birth. A referral from Sarasota Memorial Hospital gave Rottgers a chance to meet with the expecting parents and provide prenatal consulting on what to expect and how the cleft lip and palate would be addressed.

Having a baby should be one of the most special times in their life. We want to make sure we address all of their concerns so they can enjoy it.


Dr. Alex Rottgers, M.D.
Pediatric Plastic and Craniofacial Surgery 

“We were so relieved to find Dr. Rottgers. We knew instantly he was the doctor we wanted,” recalls Melissa, Camden’s mom. “He sat and talked with William, Camden’s dad, and me. He reassured us of everything. Dr. Rottgers provided stats and percentages. He created a complete timeline of everything that was going to take place with Camden’s care. It was so helpful and it meant so much to us to be that prepared going into the birth.”

"We want our families to know that everything is going to be OK. We have an expert team and a plan to make sure their child gets the best outcome possible,” Rottgers says. “Having a baby should be one of the most special times in their life. We want to make sure we address all of their concerns so they can enjoy it.”

After meeting Camden’s family for prenatal consultation, Rottgers anticipated his parents would likely turn to the internet for more information. To provide further peace of mind, he contacted Melissa and William by phone to reassure them once again, Melissa recalls with a laugh. Camden has a more severe cleft and his timeline includes up to six or seven surgeries and procedures throughout childhood. At nine months old, he has successfully completed the first three.

I can’t come up with the words to describe how I felt when he came out of surgery. It was amazing how beautifully it all turned out. Most of all, he’s healthy.

“One of our main focuses with a cleft lip is pre-operative molding, which can make all the difference in the patient’s outcome. We close the cleft and properly line it up as a first step, laying the foundation for better symmetry and a nicer aesthetic,” Rottgers explains. “You only get one opportunity to fix a cleft lip correctly. A little extra work at the start sets the patient up for future success. It also allows us to do a more effective operation on the nose, which is the most difficult part of the condition to treat. We do dental impressions at three months of age and create a personalized pre-surgical orthodontic devise. We are moving bone, not teeth, but a process like this requires the specialists of our team orthodontists to ensure that everything moves smoothly. Once the devise has done its job, we can repair the lip and palate.”

For now, Camden gets a break from surgery for a few years. He has completed his cleft lip and palate repair, but the Cleft/Craniofacial team will continue to follow him closely as he grows and develops. Soon he will enter the phases of language and dental development. The speech pathologists, dentists, and orthodontists will play a big role in his care. His family, once tearful and afraid, is thrilled with his progress.

“I can’t come up with the words to describe how I felt when he came out of surgery,” Melissa recalls. “We were so prepared for what to expect, and they literally called us from the operating room while he was in there to reassure us. It was amazing how beautifully it all turned out. Most of all, he’s healthy.”

“Look, Dr. Rottgers loves my son,” she concludes with confidence and pride. “He is so kind and loving to Camden. He has known him since birth. The entire medical team is in awe of him and how far he’s come. They are like family to us and it is such a good feeling knowing that they will care for him throughout his childhood. I don’t have to ever worry about handing him off to another physician. This is it for us.”

Johns Hopkins All Children's Plastic and Reconstructive Surgery

Fully accredited by the American Cleft Palate and Craniofacial Association, the cleft and craniofacial team at Johns Hopkins All Children’s Hospital treats patients with congenital and acquired abnormalities of the head and neck. The most common conditions the team treats include cleft lip and palate, craniosynostosis, hemifacial microsomia, facial paralysis and deformities of the ears and jaws. Less common conditions such as Apert syndrome, Crouzon syndrome, Treacher Collins syndrome and craniofacial clefts also are treated through the multi-disciplinary program. A customized treatment plan is devised to meet each patient’s needs.
 

Visit http://viewer.e-digitaledition.com/i/848641-summer-2017/0? to read the complete Summer 2017 issue of Leading Care magazine, where this story first appeared.


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