Team provides specialized care for an infant’s craniofacial disorder.

When Ariana was a newborn, her mom, Nancy, noticed that her head looked long and narrow. The Union County mom shared her concerns with Ariana’s pediatrician, who referred her to a pediatric neurologist. However, Nancy was unable to get an appointment as soon as she had hoped. “I was desperate,” she says. “I needed answers.”

The Right Diagnosis

Nancy turned to Lawrence Daniels, M.D., a pediatric neurosurgeon at K. Hovnanian Children’s Hospital at Jersey Shore University Medical Center. Through computed tomography (CT) imaging, Dr. Daniels, who is also part of The Neuroscience Institute at Jersey Shore, discovered that Ariana had craniosynostosis.

This is a birth defect in which one or more sutures, the fibrous bands of tissue that connect the bones of the skull, close too early. “Ariana had the most common type of craniosynostosis, which affects the suture running along the top of the head, from front to back,” Dr. Daniels says. “The early closing of this suture, before the brain fully forms, causes the baby to have a long and narrow skull and a broad forehead.” Untreated craniosynostosis can lead to increased pressure on the brain and developmental delays.

Ariana’s condition was severe and required action. Dr. Daniels felt the best treatment was cranial vault remodeling. This specialized surgery, performed jointly by a pediatric neurosurgeon and a pediatric craniofacial plastic surgeon, reshapes the skull to correct the condition and enable the brain to grow normally.

An Expert Team

For Ariana’s surgery, Dr. Daniels worked with Francesco Gargano, M.D., a pediatric craniofacial plastic surgeon at the Children’s Hospital. Both specialize in surgery for complex craniofacial abnormalities. The Children’s Hospital takes a multidisciplinary approach to craniofacial surgery that involves neurosurgeons, craniofacial plastic surgeons, neurologists, geneticists, orthodontists, speech pathologists, nurses, social workers and child-life specialists.

“This is a true team effort,” Dr. Gargano says. “We have a highly skilled team in the operating room, caring for patients postsurgery in the Pediatric Intensive Care Unit, and specialists who are at the forefront of their respective disciplines.”

Successful Surgery

On June 1, at age 4 months, Ariana became the first patient to have cranial vault remodeling at the Children’s Hospital. Dr. Daniels made an incision over the top of her head from ear to ear and removed two-thirds of the skull at the back of the head. Then Dr. Gargano cut the bone into pieces to reshape the skull. Both doctors then repositioned the bones and fixed them in place with absorbable plates and sutures.

The surgery lasted just more than four hours. To the delight of Nancy and her husband, Paul, Ariana came through it beautifully. Today, she is meeting developmental milestones and enjoying music classes.

“Dr. Daniels walked me through what to expect every step of the way,” Nancy says. “The care we received was outstanding.”