Pediatric Craniofacial Surgery
Dr. David Wilson’s primary focus is treating patients born with cleft lip and palate and other craniofacial differences. He has performed hundreds of surgical procedures for the treatment of cleft lip and palate.
Craniosynostosis:
Craniosynostosis is a skull malformation that results in premature fusion of one or more of the bone plates in infancy. It can cause brain growth restriction with negative neurological consequences. It requires surgical repair before the age of one. This surgery is a team approach which is coordinated with Dr. Wilson and a pediatric neurosurgeon.
Most children born with craniosynostosis are otherwise healthy and have no family history. However, genes may play a role. There are blood tests to look for mutations of EFNB1, FGFR1, FGFR2, FGFR3, and TWIST which are common in craniofacial syndromes with craniosynostosis. Craniosynostosis patients may deal with ophthalmological issues, sleep apnea, and insufficient jaw growth.
Corrective Jaw Surgery (Orthognathic Surgery):
Corrective jaw surgery is often indicated when unequal growth of the jaw results in bite problems that cannot be corrected by braces alone. Jaw misalignment can result in difficulty with chewing, biting, swallowing; speech problems; chronic jaw or TMJ pain; open bite; protruding jaw; and breathing problems. These treatments are typically coordinated with an orthodontist and/or a multidisciplinary team. Corrective jaw surgery can now be planned with specialized software to help predict the shape of the patient’s face after surgery. Advancements in technology now allow surgeons to create 3D printed surgical guides and facial hardware. This permits Dr. Wilson to achieve a correct bite, aesthetic face, and an enlarged airway.
Pediatric Pathology:
Pediatric pathology is defined as structural and functional deviations from normal and can arise as growths and tumors of the face, skull, and jaw. It can affect one in every 50 infants. Continuous improvement in imaging and an expert in craniofacial surgery is necessary to treat these conditions properly in the pediatric population.
Pediatric Facial or Craniofacial Trauma:
Craniofacial growth and development are particularly important factors to consider when treating children who have suffered facial trauma. The initial injury requires prompt attention. Due to the changing development of the craniomaxillofacial region, secondary asymmetries can often persist. Dr. Wilson is equipped to provide comprehensive facial rehabilitation.
Sleep Apnea in Pediatrics:
Sleep apnea in children differs from that of the adult population. It can affect feeding, weight gain, cognitive development, and behavioral issues. Treatments for obstructive sleep apnea are complex and require a team approach. Surgical care will be coordinated with Dr. Wilson, a neurologist, and an ear, nose, and throat (ENT) physician.
Sleep Apnea in Adults:
Sleep apnea is an increasing problem in the general adult population. There are adverse outcomes from untreated obstructive sleep apnea, including sleepiness, inattention, fatigue, cardiovascular morbidities, and increase in mortality. Maxillomandibular advancement is a surgical treatment for sleep apnea, which opens the airway 3-dimensionally.
Plagiocephaly:
Plagiocephaly refers to a flat spot on a baby’s head due to preferential sleeping, intrauterine positions, or torticollis. The treatment of plagiocephaly is not surgical. Dr. Wilson can educate parents on repositioning techniques or custom helmet therapy to improve head shape.
Difficulty Breast Feeding/Tongue-tie
Sometimes infants experience difficulty breastfeeding because their frenulum, the small fold of skin that prevents the tongue from moving too far, is too short or tight. In this situation, Dr. Wilson can perform a simple procedure called a frenulectomy or frenectomy to improve an infant’s ability to breastfeed.