Cedars-Sinai Craniofacial Clinic Director Leads Team of Medical Specialists Dedicated to Restoring A More Normal Appearance to Children With Facial Deformities

Each year approximately one in every 500 U.S. infants is born with a craniofacial disorder (an abnormality of the face or head). Some children with problems such as cleft lip or cleft palate require multiple surgeries – often starting when the baby is just 10 weeks old – and continuing in phases throughout the youngster’s childhood and into young adulthood. Over the years, these children, their families and their doctors often form extraordinary friendships and it’s not uncommon for the craniofacial specialists to hear about first dates and even be invited to their young patients’ graduations and weddings. Director of the Cedars-Sinai Craniofacial Team, Mark M. Urata, M.D., D.D.S., brings expertise in two types of surgery ― plastic and reconstructive surgery and oral and maxillofacial surgery ― to his role as leader of a team of specialists dedicated to restoring a more normal appearance to children with craniofacial problems.

Los Angeles - June 21, 2005 - “I just want to stand in line in the grocery store and not have people stare at my child or ask me questions about what happened to him.”

Mark M. Urata, MD, DDS, director of the Cedars-Sinai Craniofacial Clinic, hears this often from parents of children with craniofacial problems (abnormalities of the head and neck). It’s common, he says, for a parent to want other people to see their child the same way they do. But parents of children with craniofacial anomalies sometimes believe this is impossible because their child looks so different from others.

“Our job is to do what we can so that others can see the child as their parents do. We have an opportunity every day to make a change in a child’s appearance that will almost immediately have a positive effect on the rest of their life.”

Reconstructing a child’s craniofacial problem often starts with setting aside the parents’ guilt. A child’s mother, he says, often thinks – erroneously – that she did something that caused the deformity ― maybe it was a cup of coffee she drank in her second trimester of pregnancy.

“One of the first things I tell new parents, mothers in particular, is that in most instances we don’t know why this (their child’s deformity) happened … it was simply out of chance. In those cases, I let them know that there was nothing they could have done to prevent it. Saying this has a tremendous effect on them. Afterward, they’re able to move past their guilt so that we can work together to reconstruct their child.”

According to Urata, one infant in every 500 is born with a craniofacial disorder. The most common disorder is cleft (separation of the) lip or palate which occurs in one of every 800 babies, making it a common birth defect. Other craniofacial disorders treated at the Cedars-Sinai Craniofacial Team are anomalies of the ear, nose, eye and periocular area and cranial anomalies including craniosynostosis (a condition in which the sutures between the cranial bones of the skull close prematurely).

“In our society, it’s unfortunate that the things that can be seen are often what we’re judged on,” Urata explains. “Young children with craniofacial problems are judged at a very early age on how they look. Even infants can sense when someone points a finger at them or stares at them and those experiences can affect their early development. At the craniofacial center we try to effect changes so that by the time a child reaches school age or earlier he has an appearance that is fairly normal and doesn’t attract undue attention.”

Children with craniofacial problems often need the skills of more than one medical professional. Children treated at the Cedars-Sinai Craniofacial Clinic are seen by a variety of medical specialists who work together to develop a comprehensive treatment plan. The team includes experts in plastic surgery, otolaryngology (ear/nose/throat conditions), pediatric neurosurgery, pediatric ophthalmology (care of the eyes), dentistry and oral surgery, clinical genetics, nursing, pediatrics, speech pathology, occupational therapy, orthotics, physical therapy and social services.

“We’re establishing a world-class craniofacial center at Cedars-Sinai with a team that’s capable of handling the most difficult craniofacial anomalies and presentations,” explains Urata, who is uniquely qualified to be the Team’s director. He received a doctor of dentistry degree from the University of Southern California (USC) School of Dentistry and completed residency training in oral and maxillofacial surgery at Los Angeles County (LAC) and USC Medical Center. He then attended medical school, receiving his medical degree from USC School of Medicine. Following an internship and residency in general surgery at LAC and USC Medical Center, he completed a residency in plastic and reconstructive surgery at USC and a fellowship in craniofacial surgery at the University of California, Los Angeles. He is an assistant professor of plastic surgery at the Keck School of Medicine at USC and is involved in research on the molecular causes of craniofacial anomalies at USC’s Center for Craniofacial Molecular Biology.

Some children with craniofacial problems such as cleft lip (a separation of the upper lip) and/or cleft palate (a separation of the roof of the mouth) often require more than one surgery, “We sometimes follow a child with a cleft lip or cleft palate from birth to age 20. The first surgery is generally done when the child is about 10 weeks old and the others are completed in phases. “It’s nice for us because we get to watch these children grow up. We get to hear about their first dates and often get invited to their weddings,” adds Urata.

“The nice thing about what our team accomplishes is, at the end of the day when we’re driving home in Los Angeles traffic, we’re thinking ‘it’s not such a bad drive’. That day we had the opportunity to change a child’s life and that’s a tremendously rewarding feeling.”

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