Overview of Congenital Nasal Deformity Repair
Congenital nasal deformities can have a significant impact on both the appearance and function of an individual's nose. These deformities may be present at birth due to various factors, such as genetic mutations, environmental influences during pregnancy, or a combination of both. Repairing congenital nasal deformities often requires a comprehensive approach that involves a team of specialized medical professionals, including plastic surgeons, otolaryngologists, and craniofacial specialists. In New York City, there are several renowned hospitals that excel in the treatment of congenital nasal deformities. This article will introduce some of the top institutions in the city.
NewYork - Presbyterian Hospital
Craniofacial Centers at NewYork - Presbyterian
NewYork - Presbyterian is well - known for its excellent craniofacial centers. According to its official information, the craniofacial team at this hospital has a long - standing tradition of providing high - quality care for children with craniofacial abnormalities and craniosynostosis.
For prenatal cases, if a prenatal ultrasound is suggestive of a craniofacial disorder, the team meets with the expecting parents. They offer support and plan a course of action after the baby is born. When it comes to evaluations for infants and children, the appointment includes a complete assessment of the child’s health and function. Given that disorders of the face and skull can involve more than just appearance, systemic evaluation, genetic analysis, and familial planning are available when appropriate.
Treatment Approaches
Surgery for Craniosynostosis
Surgery is the only effective treatment for craniosynostosis, as fused sutures (bones of the skull) must be opened to allow the brain to expand. There are different surgical options:
- Traditional open surgical procedures: Known as cranial vault remodeling and vertex craniectomy, these are extremely safe and produce excellent results. A neurosurgeon removes the affected or closed suture and then “remodels” the skull. The surgery usually takes between two and six hours and requires three to five days in the hospital, depending on the age of the child and which suture is involved. Some children may need blood transfusions during the surgery, and a compatible parent may donate blood. No helmet therapy is needed after traditional surgery.
- Endoscopically assisted strip craniectomy: This is a newer, minimally invasive approach. Similar to the traditional approach, a neurosurgeon removes the closed suture, but cranial remodeling is not included during the surgery. This procedure is typically performed on infants younger than three months of age, relying on rapid brain growth to help reposition the cranial bones. It usually takes less time in the operating room and requires a shorter hospital stay. After the surgery, the child will wear a cranial remodeling helmet to help reshape the skull.
Facial and Cranial Reconstruction
The plastic and craniofacial surgeons at NewYork - Presbyterian perform reconstruction of facial clefts (including cleft lip and cleft palate), cleft lip revision, ear malformations (such as microtia), facial asymmetry, craniosynostosis, and a variety of other facial and cranial abnormalities. They can shift the bones of the head and face into more natural positions. Sometimes, the technique of “distraction osteogenesis” is used to achieve these changes gradually, providing children with a more functional and cosmetically appealing result.
Maxillofacial Reconstruction
The oral surgeons, trained in pediatric oral surgery, perform maxillofacial reconstruction, mainly of the bone and teeth. They treat children who have acquired a deformity from trauma, tumors, or congenital abnormalities. They also perform surgery to correct facial asymmetries and adjust the alignment of the jaws and other facial structures as children grow. Additionally, prosthodontists perform presurgical procedures such as nasoalveolar molding (NAM), expanding the palate and preparing the child's bite to ensure stability after surgery and correcting jaw discrepancies and dental arches before cleft lip and palate surgery.
Ear/Nose/Throat Surgery
The otolaryngologists at NewYork - Presbyterian evaluate and care for children with hearing, swallowing, and respiratory problems related to craniofacial conditions. They can identify ear fluid or congenital abnormalities that interfere with hearing, perform surgery to treat correctible hearing issues, and offer hearing aid support, including specially designed hearing aids and cochlear implants for eligible children. They also evaluate and treat upper airway problems using flexible scopes, even in very small infants.
Eye Surgery
The craniofacial program at NewYork - Presbyterian features oculoplastic surgeons who perform reconstruction of eye structures.
Timing of Surgery
The timing of surgery is crucial to minimize the impact of the craniofacial abnormality on cranial and facial growth, development, function, and appearance. For example, if a newborn has a cleft lip and palate, lip repair surgery is usually performed at about two to three months of age, followed by palate repair between the ages of six and 15 months. When the child approaches school age, another surgery on the back part of the palate may be done to improve speech. Between the ages of six and 10, a bone graft may be performed. At 15 or 16 years, the upper jaw may be repositioned if needed. Throughout this process, the child may have orthodontic therapy and see a pediatric dentist to maintain oral health.
Mount Sinai Hospital
Pediatric Ear, Nose, and Throat Services
The pediatric ear, nose, and throat physicians (otolaryngologists) at Mount Sinai are fellowship - trained and focus on providing an excellent parent and patient experience. They take the trust placed in them by patients and their families seriously and strive to customize treatment plans.
With experience in all facets of pediatric otolaryngology, the team of experts at Mount Sinai provides the most up - to - date recommendations. This empowers families to make the right treatment decisions for their child. The team educates parents about the child’s specific disease processes and communicates effectively with referring physicians.
Pediatric Conditions Treated
The dedicated pediatric ENT team at Mount Sinai treats a wide range of ear, nose, and throat conditions affecting children and adolescents. These include:
- Airway and breathing disorders - Pediatric aerodigestive program
- Feeding disorders
- Speech and language disorders
- Ear disorders
- Nasal disorders
- Snoring and obstructive sleep apnea (OSA)
- Congenital and acquired neck masses
- Cleft lip and palate
- Vascular birthmarks and malformations
Multidisciplinary Pediatric ENT Care and Specialty Services
Collaboration with other pediatric specialists is a critical aspect of the work at Mount Sinai. The pediatric otolaryngologists work closely with referring physicians and all disciplines within the department of pediatrics, such as allergists, pulmonologists, gastroenterologists, facial plastic and reconstructive surgeons, and hematologists/oncologists. The team also offers specialty services, including audiology, speech therapy, cochlear implants, and hearing aids.
Mount Sinai is unique in that its team has both interest and training in several areas of pediatric otolaryngology that are difficult to find elsewhere. They offer sialo endoscopy for the management of certain salivary gland disorders and are trained in sleep endoscopy for the evaluation of complex obstructive sleep apnea. They work together with other specialists to provide multidisciplinary care to patients with complex conditions of the upper airway, gastrointestinal tract (GI), and pulmonary systems disorders through Mount Sinai’s multidisciplinary aerodigestive and complex airway clinic.
NYU Langone Health
Division of Facial Plastic & Reconstructive Surgery
The division of facial plastic and reconstructive surgery in NYU Langone Health’s department of otolaryngology — head and neck surgery is highly regarded. It provides training for surgeons who wish to specialize in facial cosmetic and reconstructive surgical procedures for patients with hereditary or trauma - induced conditions or complications from infections and tumors.
Residents and fellows have the opportunity to train with world - renowned experts in facial reconstruction, reanimation, and rejuvenation. They gain experience in various surgeries, such as those to correct facial injuries, lacerations, and fractures; reanimation surgery for facial paralysis; reconstructive surgery for congenital anomalies; reconstruction after Mohs surgery; and functional rhinoplasty to correct nasal obstructions, including deviated septum.
Clinical Services
The facial plastic and reconstructive surgeons at NYU Langone, such as Danielle Eytan, MD, and Judy W. Lee, MD, offer a wide range of patient services. These include:
- Cosmetic procedures for aging skin, such as face - lifts, brow lifts, and blepharoplasty
- Surgical treatment for nasal obstruction
- Reconstruction for basal and squamous cell skin cancers
- Rhinoplasty, which can also be used for the repair of congenital nasal deformities
- Craniofacial surgery including cleft lip, cleft palate, microtia, and other ear malformations
The facial paralysis and reanimation center at NYU Langone is one of the few specialty centers that perform masseteric nerve transfer and free tissue transfer for the treatment of chronic facial paralysis.
Comparison of the Three Institutions
| Hospital | Specialties | Treatment Approaches | Patient - Centered Care Features |
|---|---|---|---|
| NewYork - Presbyterian | Craniofacial abnormalities, craniosynostosis, facial and cranial reconstruction, maxillofacial reconstruction, ear/nose/throat surgery, eye surgery | Multiple surgical options for craniosynostosis, distraction osteogenesis for facial reconstruction, comprehensive care from multiple specialties | Prenatal consultations, family - centered care, detailed surgical timing plans |
| Mount Sinai | Pediatric ear, nose, and throat conditions, including complex airway and feeding disorders | Customized treatment plans, sialo endoscopy, sleep endoscopy | Fellowship - trained physicians, multidisciplinary care, patient and parent education |
| NYU Langone | Facial plastic and reconstructive surgery, including cosmetic and reconstructive procedures for various facial conditions | Training with world - renowned experts, a wide range of surgical procedures for different facial disorders | Residency and fellowship training, experienced faculty, specialized centers for facial paralysis |
Importance of Choosing the Right Hospital
When it comes to congenital nasal deformity repair, choosing the right hospital is of utmost importance. A specialized hospital with experienced medical teams can provide accurate diagnoses and personalized treatment plans. These institutions have access to the latest medical technologies and research, which can lead to better treatment outcomes. Moreover, patient - centered care, including support for patients and their families, can also contribute to a more positive treatment experience. By choosing one of the top hospitals in New York City, patients can have greater confidence in the quality of care they will receive.
Conclusion
In conclusion, NewYork - Presbyterian, Mount Sinai, and NYU Langone Health are all top - tier institutions in New York City for the repair of congenital nasal deformities. Each hospital has its own unique strengths, whether it's the comprehensive craniofacial services at NewYork - Presbyterian, the pediatric - focused ENT care at Mount Sinai, or the advanced facial plastic and reconstructive surgery at NYU Langone. These institutions are staffed with highly skilled medical professionals who are dedicated to providing the best possible care for patients with congenital nasal deformities.
If you or someone you know is in need of congenital nasal deformity repair, we encourage you to further explore these hospitals. Research their services, consult with their experts, and make an informed decision based on your specific needs. By taking the time to choose the right hospital, you can be on the path to a successful treatment and a better quality of life.
