Pediatric CENTER FOR FACIAL PLASTIC SURGERY AT ENT SPECIALISTS

Pediatric

Pediatric oculoplastic surgery is a specialized field within ophthalmic plastic and reconstructive surgery that focuses on the management of eyelid, orbit and lacrimal conditions in children. Dr Dan Georgescu has expertise in pediatric cases and works to address a variety of congenital, developmental, and acquired conditions affecting the eyelids, orbits, and surrounding structures in children.

Here are key aspects of pediatric oculoplastic surgery:

1. Conditions Treated:

- Congenital Ptosis: Drooping of the upper eyelid(s) present from birth.
- Tear Duct Disorders: Conditions affecting tear drainage, such as congenital nasolacrimal duct obstruction.
- Tumors: Evaluation and management of eyelid and orbital (eye socket) tumors, which may be rare but can occur in pediatric patients.
- Orbital Fractures: Surgical repair of fractures involving the bones surrounding the eye.
- Congenital Anomalies: Addressing anomalies present at birth, such as facial asymmetry or abnormal eyelid positioning.

2. Surgical Techniques:

- Ptosis Repair: Surgical correction of drooping upper eyelids may involve repositioning or tightening the muscles responsible for eyelid movement. In certain cases where the eyelid muscles are too weak, different techniques that anchor the eyelid to the brow (frontalis suspension) may be necessary to achieve the desired result. Marcus Gunn jaw winking syndrome is treated by a combination of techniques to achieve the desired functional and cosmetic result.
Prompt treatment of congenital ptosis is key in order to avoid the development of a lazy eye (amblyopia), postural (neck) complications and psychological issues.
- Tear Duct Surgery: Procedures to open blocked tear ducts, such as nasolacrimal duct probing, balloon dilation and stent placement are typically performed around one year of age in those children where the tear duct does not open spontaneously. Endoscopic Dacryocystorhinostomy (DCR) surgery is sometimes required for children that are lacking the bony nasolacrimal canal and can be performed after 3 years of age.
- Eyelid Reconstruction: Repair of eyelid defects or abnormalities through various reconstructive techniques.
- Orbital Surgery: Surgical interventions to address conditions affecting the eye socket or orbital structures. Benign (non-cancerous) tumors are removed completely at one setting and typically result in complete cure. Malignant (cancerous) lesions are normally first biopsied, as full treatment involves a combination of surgery, chemotherapy and radiation.

3. Anesthesia:

- Consideration for Pediatric Patients: Anesthesia choices are made with careful consideration of the age and health of the child. Dr Georgescu works only with specialized pediatric anesthesiologists that have considerable experience in taking care of children.

4. Collaboration with Pediatricians and Specialists:

- Multidisciplinary Approach: Dr Georgescu often collaborate with pediatricians, pediatric ophthalmologists, and other specialists to provide comprehensive care.
- Management of Systemic Conditions: Addressing eyelid conditions associated with systemic disorders usually requires coordinated care and a multiteam approach.

5. Postoperative Care:

- Monitoring: Close postoperative monitoring to assess healing, ensure optimal outcomes, and address any potential complications.
- Rehabilitation Exercises: In some cases, rehabilitation exercises may be recommended to optimize functional outcomes. Eye patching to either prevent or treat amblyopia is frequently done after ptosis (droopy eyelid) surgery to stimulate the weak eye to develop.