Variety Center for Craniofacial Rehabilitation
Sponsored by The Variety Club of New York, this conference for patients with severe cranial and facial birth defects is directed by Dr. Joseph G. McCarthy. In addition to Dr. McCarthy, the team consists of the Institute’s other craniofacial surgeons: Dr. Court Cutting; Dr. Charles Thorne and Dr. Barry Zide; microsurgeon, Dr. John Siebert; surgical orthodontist, Dr. Barry Grayson; prosthodontist, Dr. Lawrence Brecht; pediatric neurosurgeons, Drs. Jeffrey Wisoff and Howard Weiner; pediatric ophthalmologist, Dr. Mark Steele; pediatric otolaryngologist, Dr. Joseph Bernstein; genetic counselor, Elsa Reich; Social Worker, Dennis Sklenar, CSW; Clinical Psychologist, Dr. Aileen Blitz; and Nurse Practitioner and Team Coordinator, Patricia Chibbaro, R.N., M.S.. Each specialty team Conference offers patients a comprehensive evaluation of their particular condition. Craniofacial surgery can now make impressive improvements in such conditions as orbital hypertelorism (widely spaced eye-sockets), craniosynostosis (the premature closure of cranial sutures and risk of impediment to brain growth), and craniofacial microsomia (underdevelopment of one side of the face).

Many children and young people whose families are unable to pay for the clinical services or the cost of accommodation, are sponsored directly by the NFFR and in these situations the surgical fees are provided pro-bono by the Institute's doctors.

The Craniofacial Center is internationally recognized for its contributions to craniofacial surgery: techniques for correcting orbital hypertelorism, pioneering procedures for infant surgery for craniosynostosis, determining the role of vascularized bony transfers and cranial bone grafts, using microvascular free flaps for soft tissue restoration, creating three-dimensional computer graphic and conducting the laboratory studies that led to the first craniofacial distraction procedure in 1989.

Cleft Lip and Palate Center
Dr. Court B. Cutting is the Director of the Cleft Lip and Palate Center. He is joined by Drs. Barry Grayson, surgical orthodontist and Lawrence Brecht, prosthodontist; Drs. Paul Hammerschlag and Joseph Bernstein, otolaryngologists; Elsa Reich, genetic counselor; Shelley Cohen, MA, CCC-SLP, Speech-Language Pathologist; Dr. Aileen Blitz, Psychologist; Patricia Chibbaro, R.N., M.S. Nurse Practitioner; and Dennis Sklenar, CSW, Social Worker.

The team’s philosophy is to treat those born with cleft lip and palates while they are babies so that they will not have to go through childhood with a major facial deformity, avoiding surgery whenever possible. Drs. Cutting and Grayson developed a technique of pre-surgical molding to reduce the severity of the cleft and the deformity of the nose. A molding plate placed preoperatively corrects the deformity of the nose commonly associated with clefts and the infant’s nose can be reshaped without surgery, especially if done during the first few months of life when the nasal structures are highly malleable.

Other issues addressed at the team conference include timing and type of surgery, orthodontic/prosthodontic therapy, speech therapy and psychosocial support for the patient and family.

Center for Developmental Ear Anomalies
Dr. Charles H. Thorne is the Director of the Microtia Team Conference which addresses problems of the ear. Other members include Dr. Lawrence Brecht, prosthodontist; Dr. Paul Hammerschlag, otologist; Elsa Reich, genetic counselor; Dr. Aileen Blitz, psychologist; Patricia Chibbaro, R.N., M.S. and Dennis Sklenar, CSW, Social Worker.

Patients with microtia (small, abnormally-shaped or absent external ear), aural atresia (absence or incomplete formation of an external ear canal) and other deformities involving the ear are evaluated by the multidisciplinary team. Microtia and aural atresia can occur as an isolated condition or in conjunction with other anomalies affecting the ear, bones of the face, soft tissue of the cheek and function of the facial nerve. Microtia also occurs in Treacher Collins syndrome. Patients with microtia should be evaluated by a team of specialists which includes a genetics counselor so that the parents can be informed of any increased risk of these syndromes in future children.

Center for Vascular Malformations

Head and Neck Vascular Anomalies
Drs. Fran Blei and Barry Zide are the Co-Directors of the Head and Neck Vascular Anomalies Conference. Drs. Nolan Karp and Fran Blei are the Co-Directors of the Trunk and Extremity Vascular Anomalies Conference. The multidisciplinary teams also consist of a genetics counselor, a pediatrician, an interventional radiologist, a dermatologist, a psychologist, a social worker and a nurse practitioner.

Vascular malformations (congenital growths or "birthmarks") and hemangioma (blood vessel tumors) behave differently and require a wide variety of treatments. Capillary malformations (port-wine stains) are usually treated by laser. Lymphatic malformations often require surgical removal. It is difficult to differentiate between the various types of hemangioma and vascular malformations, making it important that an experienced multidisciplinary team be involved. Also, because these growths can involve the eye, brain, respiratory tract and other organs, no single medical specialist is capable of caring for every aspect of these complex cases.

Trunk and Extremity Anomalies
This monthly multidisciplinary team conference dedicated to congenital and post traumatic problems of the hand and upper-extremity is conducted by Drs. Robert W. Beasley, David W. Friedman, Mihye Choi, and Michael Hausman (Mt. Sinai Orthopedics), along with Dr. Golimbu, Radiologist; Dr. Effron, Neurologist; Winnie Tsui, Occupational Therapist; and Louise Rizzo, Hand Therapist.

Center for Psychosocial Support
The Newman Psychosocial team consists primarily of three dedicated professionals: Aileen Blitz, Ph.D., Clinical Psychologist; Dennis Sklenar, Social Worker; and Patricia Chibbaro, R.N., M.S., Pediatric Nurse Practitioner, who care for the psychological and social needs of the patients and their families. The philosophy of the Institute has always been that excellent surgical outcomes alone are insufficient; the goal is to strengthen families and to help each child develop a healthy self-image and the confidence to pursue a full and rewarding life. The team works closely with the genetic counselor, speech pathologist and a clinical supervisor.

Center for Craniofacial Prosthetics
Drs. Charles H. Thorne and Lawrence E. Brecht direct this center. The technology of osseointegrated implants, which was originally developed for intraoral use to retain dentures, has been expanded for use in other areas of the face: ears, eyes, nose. A comprehensive program has been established at the Institute for the prosthetic rehabilitation of patients with facial defects resulting from tumor removal, burns, trauma or congenital deformities.

Microsurgery Clinical Services
The Institute of Reconstructive Plastic Surgery has played a major role in the development and refinement of microsurgical techniques for the ultimate benefit of patients worldwide. Dr. William Shaw created the Bellevue Replantation Service, which helped refine the techniques of limb and finger salvage surgery. Dr. John Siebert has pioneered the use of microvascular free tissue transfer to reconstruct congenital or acquired facial asymmetries and deformities. Drs. Nolan Karp and Armen Kasabian helped to elucidate the optimal treatment of limb threatening wounds and ulcers in diabetic and post-traumatic patients. Dr. David T.W. Chiu has developed an international reputation in peripheral nerve surgery. Dr. Christina Ahn specializes in state-of-the art microvascular breast reconstruction. Dr. Mark Delacure, previously Chief of Head and Neck Oncology at Roswell Park Cancer Center has joined the faculty to add further experience in the field of head and neck oncology and reconstruction.

Center for Ophthalmic Plastic Surgery
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