Improving outcomes, sharing results

Published on September 14th, 2020 by Christina Echegaray.

Operate, innovate, educate.

It’s a simple phrase that sums up the mission of the Vanderbilt Cleft and Craniofacial Program, says medical director Michael Golinko, MD.

“This is primarily a surgical program, so ‘operate’ refers to the variety of surgical procedures we perform, and it also includes all of the interventions or therapies that a child might need,” Golinko says. “We want to operate — do everything that we do — with the highest quality, the best surgical metrics and the best patient and family experience. This drives us to ‘innovate,’ and then we ‘educate’ — we share our experiences and innovations with colleagues and with families.”

As part of an academic medical center, the program has robust ongoing research projects and is committed to training the next generation of cleft and craniofacial surgeons and specialists.

The program maintains a large registry of patients to define and improve outcomes and is using surveys to study the family experience with the multidisciplinary cleft and craniofacial team.

Hearing and Speech Sciences investigators are studying speech outcomes related to the different syndromes children have and the types of surgical repairs and additional speech-related surgeries they need, says James Phillips, MD, cleft team co-director and assistant professor of Otolaryngology – Head and Neck Surgery.

The program is also beginning a study of hearing bands — a soft headband containing a hearing aid that transmits vibrations to the inner ear — to address hearing loss from fluid in the middle ear.

“Children with clefts have inherent Eustachian tube dysfunction and end up getting a lot of fluid in their ears that require management with ear tubes or more advanced ear surgeries,” Phillips says. “To minimize anesthesia, we usually wait until the palate repair surgery to put in ear tubes.”

This approach, however, leaves children with muffled hearing until they have the palate repair and ear tube surgery. The researchers will test if wearing a hearing band corrects the conductive hearing loss.

The program is also participating in a multi-center study using a special type of magnetic resonance imaging to study the effect of cranial vault remodeling for craniosynostosis on brain development.

“This will be the first study to look pre- and post-op to see how the white matter tracts in the brain are changing and normalizing with surgery,” Golinko says.

Team members routinely attend national meetings to share research findings and learn the latest innovations from other centers.

“We bring back new information so that we are always providing state-of-the-art evidence-based compassionate care to our patients,” Golinko says.

The Vanderbilt program is nationally accredited for meeting the American Cleft Palate-Craniofacial Association standards of care and is held accountable to national rules and regulations.

– by Leigh MacMillan