Bill Klaproth (Intro): Welcome to Pediatric Insights, Advances and Innovations with Children's Health, where we explore the latest in pediatric care and research. Today's episode is a special edition featuring our In the Know Series, a new edition to our podcast lineup that brings you insightful conversations with our Chief Medical Executive, Dr. Dai Chung and expert physicians from across Children's Health. We'll be sharing these special episodes regularly to keep you informed on emerging trends and advancements in pediatric care straight from the leaders who are shaping it.

In this episode, Dr. Chung is joined by Dr. Patrick Wong, Division Director of Oral and Maxillofacial Surgery at Children's Health and Assistant Professor at UT Southwestern. Together, they discuss the oral maxillofacial program and how it's providing advanced care for children with facial and jaw conditions. Let's dive in.

Dr. Dai Chung (Host): I'm Dai Chung. Welcome to the In the Know video series. Welcome. Today, we have Dr. Patrick Wong, who's an Assistant Professor of Surgery at UT Southwestern Medical Center, Department of Surgery and Director of Pediatric OMFS Program. Welcome.

Dr. Patrick Wong: Thank you very much for having me, Dr. Chung. Great. It's great to be here.

Host: Great having you here. Well, first of all, elaborate what does OMFS stand for, and can you tell us more about it?

Dr. Patrick Wong: Sure. So, OMFS stands for oral maxillofacial surgery. We treat pediatric patients who have conditions that affect their mouth, jaws, and face.

Host: Well, great. Then, tell us the program that we have at Children's Health, then UT Southwestern.

Dr. Patrick Wong: We're developing the pediatric oral maxillofacial surgery division. Here, we are kind of unique because we are basically the only program in North Texas to have a pediatric-trained oral maxillofacial surgeon, and so our program helps kind of assist some of the other programs such as Dr. Kane's team of plastic surgeons and the craniofacial team. We work closely with Dr. Park and the craniofacial orthodontists here at Children's as well as the pediatric dentists. So, we really are focusing on treating patients in the North Texas area with these needs.

I've been here for a little bit less than a year, and we've already done close to a hundred cases in the OR. Our clinic, which basically started this year, has already seen over 230 patients and had over 380 appointments. So, it's starting to take off. And most of those numbers are in the last six months so it's only going to get busier, I think.

Host: It's quite a impressive record first year. Can you elaborate on your team members and who's all made up of your OMFS team?

Dr. Patrick Wong: Sure. So, I serve as the division director. We also have non-pediatric oral maxillofacial surgeons who also come and bring some of their cases here to Children's. I have my clinic manager who I work with, as well as my staff of dental assistants. I also share a clinic with Dr. Park, our craniofacial orthodontist. So, we work very closely together and are highly collaborative on our cases. So, it's nice to have a point-of-care consult if you need it right there.

Host: What are some specific advantages of having a child brought or come to Children's Health for the care?

Dr. Patrick Wong: Here, we have a facility that's meant to treat children and the capability of having people who are trained to work with kids, used to working with pediatric patients, I think, really allows us to provide the highest level of care. A lot of patients in the region have oral maxillofacial surgery needs and need to be treated at a major medical center like this. So, we're really, for North Texas, the only place that has a pediatric-trained specialist here working at a major medical center designed for children.

Host: What's the most common diagnoses or conditions that you take care of?

Dr. Patrick Wong: The first one would probably be mandible fractures. I treat a lot of jaw fractures, both on the adult and the pediatric side.

Host: Okay.

Dr. Patrick Wong: I feel like I do one or two a week, honestly.

Host: I would assume, car accidents and stuff.

Dr. Patrick Wong: Yeah, car accidents and things like that, falls.

Host: Yeah.

Dr. Patrick Wong: I'd say the second most common surgery that I do, or a diagnosis that I do is any kind of jaw deformity requiring corrective jaw surgery. So, underbite, overbite, asymmetry, these are very common for some of our cleft patients as well as some of our craniofacial patients who may have an asymmetry. So, that's a very common surgery that I do. And then, the last thing is probably the basic oral surgery stuff, things like dental extractions and exposing teeth. I do a handful of those cases a week as well.

Host: Can you tell us a little bit about some unique or innovative programs within OMFS?

Dr. Patrick Wong: Something that's at the forefront of oral maxillofacial surgery right now is patient-specific implants. We live in an era of personalized medicine. So now, that we have advances in things like virtual surgical planning and computer-assisted surgical simulation with CT scans and 3D printing for a lot of my complex surgeries, be it corrective jaw surgery or TMJ surgery or complex traumatic reconstruction. We take the CT scans of the patients. We are able to design custom models. And we're able to actually design custom cutting guides and hardware for these patients that really allows to deliver some really precise results. It's allowed us to deliver results within a millimeter, which is very helpful in some of these complex cases where you're repositioning the facial skeleton in three dimensions.

So, this is a case that we did recently. So, this is the before model. We worked with engineers and they help us to print the exact replicas. This is the before, and you can see that this patient had what we call craniofacial microsomia, or some people refer to it as hemifacial microsomia. So, the right side of her face was much smaller than the left side of her face from birth. And you can see here she has a significant asymmetry to her lower jaw as well as her upper jaw. We worked with the engineers for a custom plan for her corrective jaw surgery. So now, we've basically placed everything now in the middle, and so her asymmetry has been corrected. This surgery allows us to put the bones in the ideal position relative to the rest of the face. So, we were able to reposition her jaws to give her a more aesthetically praising profile as well as fix her bite at the same time.

Host: Was there an implant, or how was that--

Dr. Patrick Wong: Actually, so based off of this, what they do is they actually made a custom cutting guide as well as a custom plate for the upper jaw surgery as well as the chin surgery. That's basically how we work with these engineers to kind of leverage this 3D printing and the virtual surgical.

Host: Well, you got to hold them up side by side. I mean, it's strikingly different, because of complete misalignment and how you straighten the little girl's-- how old was this patient?

Dr. Patrick Wong: So, she's 17 years old. And I saw her in clinic last week and she was very happy. It's always great to see that result in patients. I think it's a great surgery. Not only are you helping them functionally, but it's great to see the improvement in their confidence after having surgery.

Host: Oh yeah. I'm sure it was life changing. I know you trained in this area and kind of went away for further training. What is it about DFW that drew you back, or perhaps the institution, Children's Health in UT Southwest Medical Center?

Dr. Patrick Wong: I was actually born and raised in the Dallas area. So, I grew up not far from here up in Plano. I've always loved Dallas and this opportunity to work at the Premier Children's Hospital in North Texas and spearhead this division. It was like a dream come true. So, I love it here and want to stay here for a long time.

Host: Well, thank you for all the great work that you do and looking forward to many more great and exciting things out of your program.

Dr. Patrick Wong: Awesome. All right. Thank you.

Bill Klaproth (Outro): Thanks for listening to Pediatric Insights, Advances and Innovations with Children's Health, where we explore the latest in pediatric care and research. We'll be back soon with another special edition featuring our In the Know Series with Chief Medical Executive Dr. Dai Chung, where he interviews expert physicians from across Children's Health.

You can find out more at childrens.com. And if you found this podcast helpful, please rate and review or share this episode and please follow Children's Health on your social channels.