West Virginia University

West Virginia University

Phone: 855-WVU-CARE
Address: West Virginia University
Location: 1 Medical Center Drive Morgantown, WV

Meet the team

  • Dr. Hal Meltzer - Neurosurgical Director of the WVU Craniofacial Program

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  • Sebastian Michael Acton Brooke

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The Craniofacial Team at WVU Medicine Children’s is an interdisciplinary team whose mission is the distribution and delivery of care to families of children with craniofacial anomalies.

The team is comprised of specialists focused on the care of families with children born with craniofacial anomalies. The group includes surgeons, dentists/orthodontists, geneticists, speech therapists, audiologists, developmental pediatricians, ophthalmologists, behavioral therapists, and social workers. The multidisciplinary team allows your child to benefit from the consolidated knowledge of many specialists from different fields in one place and in one visit.

Surgery and proper care normally result in improved appearance and healthier, happier lives for children. Equally as important is ongoing care for related problems that may involve development and vision. A number of specialists, including plastic surgeons, neurosurgeons, developmental pediatricians, and ophthalmologists are essential for close monitoring throughout early infancy and childhood.

Close communication with your primary pediatrician or family doctor is mandatory for continuity of care of your child. The purpose of this team approach is to coordinate the best medical care for your child and to ensure that you are involved as an active partner in the treatment process.

Conditions we treat include but are not limited to:

For cases where the head is misshapen significantly, the treatment usually involves surgery. There are three reasons for surgery:

  1. Cosmetically, surgery will normalize the shape of the babies’ skull. Without intervention, the shape of the skull will not improve and may progress.
  2. While rare in cases of single suture craniosynostosis, pressure inside the skull can build, leading to neurologic problems. Expanding the skull treats or prevents this.
  3. There is an association between single suture craniosynostosis and developmental delays, especially in craniosynostosis of the metopic suture. There is some evidence that surgical treatment improves developmental outcomes.

There are two types of surgery to treat craniosynostosis. Both are involved and carry risks with each procedure.

  • Open Remodeling: In this procedure, the abnormally shaped skull bones are exposed and removed. Great care is taken to protect the brain and eyes. The bones are then molded to a normal shape, replaced, and secured with absorbable plates and screws to normalize the head shape. This surgery usually involves an ear-to-ear incision, cuts in the bone, and remodeling the shape. At the end of surgery, the shape is normalized; no helmet is needed afterward.
  • Endoscopic Strip Craniectomy: This procedure is most effective in infants less than 3 months of age with an involved sagittal sutures. Two small incisions are made and a special camera at the end of an instrument is used to visualize the fused sagittal suture. The suture is then cut out and removed. Benefits of this procedure include shorter surgical time and less blood loss. Skull reshaping is then reliant on the infant brain growing over the next 18 months. A full-time helmet must be worn to guide the reshaping of the skull.

Timing of surgery depends upon which suture is involved and the baby’s overall health and development. In general, most surgical interventions are done during the first year of life, while the skull bones are relatively soft and moldable. Most parents wish to have surgery performed as soon as the diagnosis is made. Surgery is safer and most successful when done at the proper age. Your surgeons will discuss optimal timing for your baby’s procedure. Most children need only one surgery.

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