Craniofacial Care

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Types of Craniofacial Conditions We Treat

George Kamal. MD, pediatric craniofacial surgeon, exams Parker, who has craniosynostosis.

When your child has a craniofacial condition, you want an experienced team who can make an accurate diagnosis and develop an effective treatment plan. They will also provide ongoing, long-term support for your family. The Cleft and Craniofacial team at Joe DiMaggio Children’s Hospital treats a full range of conditions that can affect your child’s head and neck. Our team focuses on providing family-centered care that puts you and your child at the center of the treatment plan.


When a baby is born, the skull has not yet fully fused together, leaving sutures (long, narrow openings) along the head. These sutures help the baby exit the birth canal and leave room for proper brain and head development. Craniosynostosis is a group of disorders in which the sutures of the skull fuse together too soon. Learn more about how we treat craniosynostosis.

Craniofacial Syndromes

Our team provides expert diagnosis and advanced treatment for all craniofacial syndromes, including:

Apert syndrome

This genetic condition causes abnormalities of the skull and face. These may include a sunken appearance, wide-set eyes, a beaked nose or some combination of the three.

Carpenter syndrome

This genetic condition occurs when a baby’s skull closes too early during gestational development. It may affect the top of the skull or the sides of the skull or both areas. Babies with this condition:

  • Are born with a skull that is short from the front to the back
  • Typically have eye sockets that are wide set and seem to slope downwards
  • Often have an upturned nose with large nostrils
  • May have unusual ears
  • May have fingers, toes or hands that are short or fused or both
CHARGE syndrome

This highly complex syndrome affects systems all over the body. It affects each child differently. Some of the most common complications include swallowing and breathing problems, hearing loss, vision loss and trouble with balance.

Crouzon syndrome

A genetic condition that causes early fusing of the skull bones, which leads to unusual head and face shapes.

Goldenhar syndrome

This rare congenital condition causes unusual ear, eye and spine development.

Long face syndrome

This syndrome causes the face to appear long and narrow. Children with long face syndrome may have problems with eating, breathing or talking.

Moebius syndrome

In this disorder, the sixth and seventh cranial nerves are missing or underdeveloped, causing problems with eye movements and facial expressions.

Muenke syndrome

This rare genetic condition causes the developing baby’s skull to fuse prematurely during gestation development, leading to a flat face, hearing problems, wide-set eyes or some combination of the three.

Parry-Romberg syndrome

In this syndrome, half of the face begins to atrophy (break down) about the time adolescence starts (around age 10 to 12). Two of the first signs of this syndrome include:

  • Changes to the pigment (color) of the skin on the face
  • Decrease in muscle tone around the mouth and eyes
Parry-Romberg syndrome is extremely rare, and researchers haven’t yet decided if there is a definite genetic link.
Pfeiffer’s syndrome

This genetic condition affects the growth of the bones of the skull, hands and feet.

Saethre-Chotzen syndrome (SCS)

SCS causes a baby to be born with:

  • Unusual skull formation
  • Webbing between their fingers
  • Droopy eyelids
  • Small ears
  • Facial asymmetry
  • A low hairline
Most people with SCS have the same level of intelligence as people who don’t have the condition. SCS is caused by an inherited mutation in a gene called TWIST1, which affects the formation of the head and limbs during gestational development.

Other Craniofacial Conditions

Our team provides expert diagnosis and advanced treatment for other craniofacial conditions, including:


This condition involves the growth of cyst-like lesions that replace the bone. It typically affects children between the ages of 2 and until puberty. Related complications involve a quickly growing jaw that causes teeth to crowd, along with other dental problems.

Developmental venous anomaly (DVA)

DVA is a congenital condition that causes unusual blood vessels — most often occurring in the spinal cord or brain. The blood vessels may be visible from outside the skin, and may look clustered together like the spokes of a wheel. DVAs are benign (not cancerous).


With this condition, an area of the brain forces itself through a weak area of the skull. The area of the brain that extends beyond the skull is known as an encephalocele.

Fibrous dysplasia

This condition causes jaw swelling and problems with the teeth. Fibrous dysplasia typically gets worse during the years the child is growing and developing. Then it goes away when the bones have finished growing.


These are benign, fluid-filled cysts that develop in children — most commonly on the head or neck. Lymphangioma happens when lymph fluid doesn’t flow normally through the body and backs up instead. In many cases, the cysts don’t need to be treated.


This condition affects babies developing in utero. It causes them to have small or extremely small eyeballs. In some cases, it can appear that the eyeball is missing completely.

Pediatric facial fracture, pediatric facial trauma or pediatric fracture

Accidents that lead to fractures (breaks) of facial, head or neck bones can cause irregularities in appearance or function. For instance, they can cause problems with breathing, eating or drinking.

Pediatric torticollis

This condition causes the head to twist unusually and tilt to one side. Torticollis is caused by a muscle spasm.

Sleep apnea

This condition interrupts breathing during sleep, and often causes snoring.

Anomalies or Malformations of the Head or Face

parker being examined by dr. hertzler

Our team provides expert diagnosis and advanced treatment for conditions that cause irregularities in the shape of the head, face, or neck, including:

  • Eye socket anomaly: Irregular eye sockets are present at birth and may cause unusual eye placement and function.
  • Congenital, facial, and craniofacial anomalies: Certain syndromes or other conditions can lead to unusual differences in the way the face or head appear. These irregularities can sometimes affect daily activities, including breathing, eating, drinking or sleeping.
  • Jaw deformity/malformed jaw: An imbalance in the upper or lower jaw may be present at birth or can be due to an injury. Problems with the jaw can affect speaking, eating, biting, smiling, breathing or a combination of any of these.
  • Nasal deformity/Nasal malformation: Unusual formations in or around the nose are congenital (present at birth), and can include deviated septum, cleft lip or other unusual appearance.
  • Skull malformation or skull anomaly: Certain syndromes or other conditions can lead to differences in the way the skull appears. These differences can sometimes affect daily activities, including breathing, eating, drinking or sleeping.

Treatments for Craniofacial Conditions

Our team offers the latest treatments for children with craniofacial conditions. When possible, we use minimally invasive procedures to minimize downtime, reduce chance of infection and reduce scarring.

Craniosynostosis repair

Our craniofacial team is proud to offer the latest in research-backed treatment options for your child. Their doctor may recommend treating craniosynostosis with traditional surgery, such as cranial vault remodeling (CVR), or with a minimally invasive surgery. Learn more about how we treat craniosynostosis.

Virtual surgical planning (VSP)

Our surgeons use VSP to carefully plan our surgical procedures. Your child’s surgeon uses computerized tomography (CT) imaging to create a 3D model of your child’s head and determine the best course of action for their treatments. Using VSP, we can often offer:

  • Reduced surgery time
  • Greater precision
  • Less time under anesthesia

Endoscopic surgeries are typically less invasive by using smaller incisions, which may mean faster healing and less downtime after surgery. Based on your child’s situation, their surgeon may be able to offer VSP for various craniofacial surgical procedures, including skull reconstruction.

Endoscopic assisted craniectomy

This procedure treats some types of craniosynostosis or early fusion of skull bones in babies. Surgeons perform endoscopic assisted craniectomies only on babies younger than four months old. During this procedure, the surgeon removes the area of prematurely fused bone.

Following surgery, your baby will need to wear a post-surgical helmet for several months. This helmet helps mold the head to a shape that better accommodates normal brain growth. This procedure is also known as a strip craniectomy or minimally invasive surgery for craniosynostosis.

Other treatments for craniofacial conditions

  • Cranial Molding Orthosis (helmet therapy): Helmet therapy can be used to slowly reshape your child’s head over time. For the most effective, fastest effect, babies should wear the helmet for 23 hours a day (taken off only during bathing). On average, babies need to undergo cranial molding orthosis for about three months, although treatment varies by child.
  • Monobloc Procedure: During this surgical procedure, your child’s surgeon reshapes the front area of the face, skull and upper jaw. The goal of the Monobloc procedure is to correct an unusual head shape.
  • Piriform Plate: Children with midface hypoplasia can be treated in an outpatient setting using this new minimally invasive device. Done under general anesthesia, surgeons place two plates on the bone along side the nose (pyriform aperture) through a small incision in the gums. The plates are held in place and the incisions are closed with dissolving sutures.
  • Skull Allograft Implant and Custom 3D Printed Alloplastic Skull Reconstruction: This surgical procedure corrects an irregularity of the skull. Your child’s surgeon removes a portion of the skull and replaces it with a 3D printed piece of surgical-grade material.
  • Rehabilitation Therapy Services: Some children with craniofacial conditions may require rehabilitation services, including feeding, language, speech therapy, occupational therapy, and physical therapy. Our speech team can also work with your local speech therapy provider if your child needs added support to improve their speech. Contact our Outpatient Rehab Therapy Center for more information.

Call to make an appointment with a cleft and craniofacial specialist:


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