People come to the Rush Craniofacial Center to get healthy. In that regard, they're just like any other patient at Rush. But unlike most patients, these people -- many of them young children -- wear their condition on their faces. They see it in the mirror each morning and they feel it in the stares of others throughout the day.

For patients with craniofacial deformities, much of the healing occurs where body and mind intersect. The injuries they have suffered, or the anomalies they were born with, can affect everything from their sight and hearing to their ability to speak and breathe easily. Consequently, a multidisciplinary approach to care is the norm.

What sets the Rush Craniofacial Center apart is how closely its team, handpicked by co-directors John W. Polley, MD, and Alvaro Figueroa, DDS, MS, works together.

"Very few places have the kind of close coordination that we have," says Polley, the John W. Curtin, MD, Professor of Plastic and Reconstructive Surgery at Rush. "That's what allows us to get the results that we get."

After initial consultations with Polley and Figueroa, many patients return on a "Team Day." On that day, they go from room to room and are seen, in turn, by a neurosurgeon, a speech pathologist, a social worker and several other specialists.

"It's a long day," says Figueroa -- one that typically stretches well into the evening. After the last patient has left, the staff assembles in the center's conference room to discuss the cases one by one and step by step. "We make our recommendations as a team," Figueroa says. "It's not just one surgeon's opinion or the orthodontist's or anesthesiologist's opinion. Everybody has their say."

Nonetheless, it all starts with Polley and Figueroa, who have been working together for more than a decade.

"We talk about patients every single day, we think about patients every single day. We see the patients together every single day," says Polley. "Our relationship is the nucleus. It's a nice marriage of the art of dentistry and the art of craniofacial surgery. When we've put the two together we've come up with some pretty unique concepts."

One of those concepts is a new treatment for the full range of anomalies that affect the middle of the face, including the ears, the eyes, the lip and the palate.

Representative of many of these conditions is Crouzon syndrome, a congenital disorder in which the bones of the face and skull fuse too soon, causing a shortage of facial bone. The result is a face sunken in appearance and eyes that seem to protrude. For decades, Crouzon syndrome and other anomalies were treated with multiple surgeries in which bone taken from the hip or ribs is used to reshape the face. By adapting the bone-lengthening techniques of orthopedic surgery for use on the face, Polley and Figueroa have been able to reduce the need for these repeated and painful procedures.

Following a surgery in which Polley makes cuts in the facial bones that need lengthening, a specially designed cranial halo -- not unlike the device surgeons use to stabilize the head and neck after spinal surgery -- is connected to the skull and teeth by screws and wires. Tiny daily adjustments made to the screws over the course of several weeks pull the face and jaw forward a fraction of an inch at a time.

"The body reacts as it would with any fracture -- it begins to heal the cuts by laying down new bone," explains Polley. "So as the device gradually pulls the face forward, the surgical cuts fill in with new bone and the facial bones are steadily elongated. This greatly improves facial symmetry and appearance. It also widens the bones forming the nasal passage and jaw, correcting breathing and the bite."

This process, known as Rigid External Distraction, is now a standard treatment around the world. It is typically the culmination of a lifelong relationship with the patient, which begins in infancy and continues into early adulthood and can include anywhere from one to four facial surgeries.

Such long-lasting relationships have given Polley and Figueroa a unique perspective on the patient experience, and this has helped them to shape the Rush Craniofacial Center.

"Our initial goal when we started planning and organizing the center was to make it friendly for the patient," Figueroa says. "We think that's important. After all, we watch many of these children grow up."

To learn more, or to arrange an appointment, contact:

Rush Craniofacial Center
Rush University Medical Center
1725 W. Harrison, Suite 425
Chicago, IL 60612
Phone: (312) 563-3000
Fax: (312) 563-2514
E-mail: jpolley@rush.edu