As a parent of a child with a craniofacial disorder, you experience the wonder and amazement that your child brings to your family every day. At AdventHealth for Children, we are here to embrace, celebrate, support and guide you through your child’s care journey.
We use leading-edge techniques and advanced technology to thoroughly diagnose your child’s specific condition. This guides our treatment recommendations and ensures that each child receives personalized care and that your family has a clear path forward. We also work in partnership with other specialists throughout AdventHealth for Children to give your child a multidisciplinary care team to meet their individual needs.
Our pediatric plastic surgeons are ready to help your child smile again. To get started, request an appointment and our Nurse Care Coordinator will contact you.
You want the absolute best for your child, and so do we. That is why you will have an entire multidisciplinary team providing them with comprehensive, coordinated care. Our cleft and craniofacial team works closely together, continually communicating and collaborating to provide the care your child needs, when they need it. The team meets regularly to discuss challenging cases and urgent needs, with a goal of providing the best care to help your family feel whole.
Your Cleft and Craniofacial Care Experts
Depending on your child’s specific craniofacial condition and customized treatment plan, your care team may include any of the following expert pediatric specialists who hold the highest certification and training in their respective fields.
As a specially trained registered nurse, Tiffani is your guide throughout your child’s treatment journey and serves as your main point of contact for any needs or questions your family may have, getting to know you and your child on a personal level to ensure the greatest care possible. As the care coordinator, Tiffani takes off the burden of scheduling appointments for various providers and facilities and helps you navigate your child's care with ease.
Your Child's Surgical Journey With Compassion and Expertise
If your child requires surgery, our Cleft and Craniofacial Nurse Care Coordinator will provide you with detailed pre-operative and post-operative guidance and counseling to ensure you feel confident, cared for and prepared for your child's procedure.
We focus on optimizing your child’s health. If needed, we will provide transfusions, supplements (such as iron), and/or blood products to provide an element of neuroprotection (preservation of the structure and function of nerve cells) and to decrease the likeliness of your child needing a transfusion during surgery.
Immediately prior to surgery, we administer gabapentin (an anticonvulsant and nerve pain medication) to reduce the need for pain relief after surgery. This may be continued at a lower dose until your child is discharged from the hospital.
Our entire craniofacial team maintains close communication amongst all members of your child’s care team, especially the surgical and anesthesia providers.
We administer a combination of local anesthetic and dexamethasone (a steroid to reduce inflammation) along with multimodal pain control, avoiding narcotics as much as possible.
We aim to minimize narcotic use while ensuring adequate pain control.
Our surgical team uses strategies to maintain near zero fluid balance, including use of autologous red cell recycling (infusing your child’s own washed red blood cells that were collected prior to surgery).
Immediately after surgery, we administer medication to control your child’s pain (using non-narcotic first-line agents) and to prevent nausea and/or vomiting (ketorolac, acetaminophen, ondansetron, hydromorphone, lorazepam).
In the post-anesthesia care unit (PACU), we will shift your child from a clear liquid diet to a mechanical soft diet as studies have proven this decreases length of stay in the hospital and improves patient outcomes when combined with the above.
Personalized, Family-Centered Care
Our entire craniofacial team is committed to providing your child with the advanced, comprehensive, whole-person care they need to thrive and reach their fullest potential. It all begins with our individualized approach. We treat more than just the body. Our team believes in working closely with each other and with your family to ease minds and lift spirits as well.
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Conducting Prenatal Consultations
Certain craniofacial conditions, such as cleft lip and palate and craniosynostosis, can sometimes be detected on prenatal ultrasound. We know any potential concern with your baby’s health or appearance can be scary. That is why we are here to listen, answer any questions you may have and provide guidance on how best to prepare for your child’s arrival. Our prenatal consultations allow you the opportunity to meet our craniofacial physician team and begin discussing the right treatment plan for your baby, prior to your delivery date. We also closely collaborate with our genetics team as needed.
Offering Second Opinions and Regional/International Consultations
We know a diagnosis of a craniofacial condition in your child — whether rare or common — can be scary and overwhelming. We want you to feel confident in the care plan for your child. That is why our experienced craniofacial surgeons are happy to review your child’s case and meet with you in person or virtually to provide you with a second opinion. In addition, we offer virtual consultations for families outside the Central Florida area and are also available to consult with your child’s local care team.
Innovative Care You Can Trust
At AdventHealth for Children, we understand that as a parent, nothing but the best will do for your child. Our team is committed to continually advancing and improving the craniofacial care we provide. This means incorporating the latest proven technologies, minimally invasive techniques and evidence-based approaches to optimize patient outcomes.
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Raising the Bar on Craniofacial Patient Care and Surgical Outcomes
According to Press Ganey surveys completed by our craniofacial patients and families after their care, 99% would recommend our program.
We also receive rave reviews from patients and their families for our team approach, bedside manner and aesthetic outcomes.
Academic studies point to higher patient volumes yielding better outcomes. We’re happy to report that the Medical Group Management Association (MGMA) has designated our craniofacial team as a >90% volume practice. In 2021-2022, we have performed:
16 cleft palate repairs
5 cleft lip adhesions
16 cleft lip definitive repairs
13 craniosynostosis open vaults/reconstructions
10 craniosynostosis minimally invasive strips
While there are always risks involved in each individual surgery and specific figures fluctuate over time, our surgical team has achieved world-class outcomes in key craniofacial surgical procedures:
Average length of stay in the hospital of only 1-2 days
Craniosynostosis
Custom, individualized planning for all patients
Average length of stay is 2-4 days (may be up to 7)
0% mortality
0% critical complications
30% transfusion rate
Mandibular Distraction
100% airway correction
0% nerve injury rate
0% ankylosis (immobility due to bone fusion)
Minimally Invasive Surgical Options
One way we rise to the challenge of continually improving the craniofacial care available to your family is through our surgical approaches and advancements. Thanks to innovative new techniques and technology for a number of surgical procedures we perform, our craniofacial surgeons are often able to operate with smaller incisions and fewer complications. For your child, that means reduced pain, smaller scars and a faster recovery.
Enhanced Recovery After Surgery (ERAS)
As a parent, you want what is best for your child. As their care provider, we do, too. That is why we use a patient-centered, evidence-based, multidisciplinary care pathway called Enhanced Recovery After Surgery (ERAS®) before, during and after your child’s surgery. It is designed to optimize the surgical outcome by reducing your child’s stress, maximizing their physiological response to surgery and promoting their recovery.
While our ERAS approach is continually evolving and improving, primary components include:
Pre-operative nutrition and hematologic (blood) optimization
Strategies to reduce the need for blood products or fluid shifts during surgery
Improved pain control as indicated by decreased opioid/narcotic use
Decreased use of intensive (ICU) care and reduced length of stay in the hospital
Ongoing Research to Enhance Treatment and Care
At AdventHealth for Children, our expert craniofacial physicians are also committed to continually improving and discovering new ways to optimize the care available to our patients. We are actively involved in numerous research protocols and ongoing national collaborations focused on innovative topics and breakthrough technologies, including:
3D imaging
3D printing
Virtual surgical planning
Augmented reality
Clinical outcomes
Neuropsychological outcomes
ERAS protocols
Our clinical team has contributed to over 50 peer-reviewed publications and is also engaged in mentorship and teaching of the next generation of craniofacial specialists.
Virtual Surgical Planning and 3D Printing
To increase surgical precision and accuracy, AdventHealth for Children uses Virtual Surgical Planning (VSP) and 3D Printing — a robust technology that allows our surgeons to preoperatively plan complex craniofacial procedures. Here is how it works:
Innovative computer-aided design software allows us to create a three-dimensional image of your child’s anatomy (for example, the skull or jaw).
Then, our surgical team holds a teleconference with a specialized engineer. Together, we design 3D, patient-specific, customized intraoperative templates, cutting guides and even implantable hardware.
The 3D printed models are created as an exact replica of your child’s anatomy and are used during your child’s surgical procedure.
This state-of-the art technology allows for a more collaborative multidisciplinary approach to pre-surgical planning, improving surgical results and decreasing your child’s time in surgery.
3D printing along with VSP technology is revolutionizing the surgical care we can provide to your child. At AdventHealth for Children, we are currently using this technology to surgically plan complex craniomaxillofacial surgery for conditions such as craniosynostosis and micrognathia. It is also an essential tool in craniofacial and mandibular reconstruction to create a more individualized approach for each patient.
I am in awe of Dr. Sawh-Martinez’s craftsmanship, thoughtfulness, and demeanor. I am floored by Rea Lynn's progress. We live an hour away, but will continue to make the drive just for this team. – Mom
Author name
Patient
Author title
Rae Lynn
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