For more information about the services we offer, please contact Head & Neck Surgical Associates today.
Head & Neck Surgical Associates
1849 NW Kearney
Suite 300
Portland, Oregon 97209
Telephone: 503.224.1371
Map
Futures Outpatient Cosmetic Surgery Center
1849 NW Kearney
Suite 300
Portland, Oregon 97209
Telephone: 503.224.1371
Map
The physicians and surgeons of Head & Neck Surgical Associates are medical doctors, as well as dentists. After medical school they continued their specialized training in various residency programs in Otolaryngology/Head and Neck Surgery, Oral and Maxillofacial Surgery and Plastic and Reconstructive Surgery.
HNSA’s surgeons have devoted their professional energies towards the management of a variety of complex problems affecting the head, neck and cranio-maxillofacial skeleton. The practice offers a number of medical procedures including diagnosis of cancers affecting the head and neck, orthognathic surgery (corrective jaw surgery), temporomandibular joint (TMJ) surgery, facial trauma surgery, cosmetic surgery and cleft/craniofacial surgery.
Our medical staff has spent their entire careers focusing upon the head and neck, thus you can be assured that you will receive the most comprehensive and specialized treatment available today. We look forward to meeting you and creating a personal treatment plan for you.
As both physicians and dentists, the surgeons at Head & Neck Surgical Associates are uniquely qualified to manage all phases of surgical care for patients born with cleft lip or other craniofacial abnormalities. Children with these complex congenital deformities require a team approach to their management including surgery, speech pathology, orthodontics, pediatric dentistry, genetics, occupational therapy, and developmental pediatrics. Recognizing the need for such a group, Dr. Eric Dierks and Dr. Bryce Potter founded the Emanuel Cleft Lip/Palate Team in 1991.
Our cleft and craniomaxillofacial surgeons are both physicians and dentists. We feel the cleft surgeon must have degrees in both medicine and dentistry to render the most effective and comprehensive care. Our surgeons, as well as our medical staff, regard “clefting” as simply a variation of nature and do not assign the terms “normal” vs. “abnormal” to children with cleft lip/palate needs. Early parental education and support is a critical element of the overall successful management of a cleft child. Parents who have recently discovered by ultrasound examination that they have a child with a cleft make an understandable and important adjustment to this finding. Our doctors and staff look forward to interacting with pregnant parents of a cleft child and help them through the process of learning about clefting and related treatments well before birth. Therefore, parents can be fully informed and prepared prior to childbirth, knowing that their newborn will be properly cared for by highly skilled and experienced surgeons.
In conjunction with members of the Craniofacial Center at Legacy Emanuel Hospital and Health Center, surgeons at HNSA treat congenital and acquired deformities of the craniofacial skeleton and soft tissues. These disorders include craniosynostosis, Apert’s Syndrome, orbital hypertelorism, temporomandibular joint (TMJ) disorders, Crouzon’s Syndrome, Treacher-Collins Syndrome, facial clefts, dental-facial deformities and facial tumors. The surgical team examines patients and discusses treatment plans weekly, allowing patients to see most or all related specialists in a single visit.
Clinic visit for general pediatric evaluation with emphasis on feeding difficulties, hearing problems, genetic counseling, dental evaluation and possible construction of dental splints or prosthesis, emotional support services and evaluation and planning for surgery. Orthodontic preparation is begun at this time.
Cleft lip repair
Construction of further dental splints if indicated, one or more hearing/ear evaluations and speech evaluation
Cleft palate repair and placement of ear tubes, if necessary
Periodic (e.g., annual or bi-annual) clinic evaluation of speech (if abnormal, speech therapy is started through school or clinic), hearing, dentition and social/emotional development.
Occasionally, palate and lip revision surgery is required and is performed during this period. Frequently, this surgery is combined with nasal surgery that is performed before the child starts school. Every attempt is made to minimize the child’s deformity prior to beginning school.
Cleft patients typically require orthodontic preparation for surgical bone graft of the cleft in the palate before permanent teeth erupt. This is performed during this period. When adequately prepared, the bone graft procedure is performed to move bone from the hip to the bone hole in the palate. Also, the speech assessment is continued during this time.
Orthodontic treatment is continued, and if necessary, minor lip and nose revisions are performed. When the jaw is fully grown (typically in the late teen years) jaw and final nasal surgery is performed if necessary.
(There are many different types of craniofacial anomalies and therefore this protocol is meant to be a general outline only.)
Clinic visit for general pediatric evaluation with emphasis on feeding difficulties, hearing problems, genetic counseling, dental evaluation, eye evaluation and possible construction of dental splints or prostheses, emotional support services and evaluation and planning for surgery. X-rays and CAT scans are typically performed to define the exact nature of the disorder.
Helmet therapy is begun to remodel the skull for babies with “crooked” skulls or plagiocephaly.
Surgery may be needed to remold and reshape the skull or upper face. This is performed as a joint procedure between the craniofacial surgeon and the neurosurgeon usually at 6-12 months of age. For children with poor skull growth, a second operation is considered during this period to ensure that brain growth is not restricted. In general, we try to correct the skull defects as soon as possible to take advantage of the younger child’s advantage in healing and remodeling bone.
For children with jaw deformities such as hemifacial microsomia, jaw stretching or distraction is typically performed at this age. Distraction typically requires two surgeries, one to place the instrument and one smaller operation to remove it. Our team routinely uses distraction instruments placed totally inside the mouth and avoids scars on the cheek whenever possible.
For children with impaired facial growth (typically seen in Apert’s, Crouzon’s and other disorders) facial advancement surgery is performed during this period.
Also during this period, speech, dental, eye, and ear evaluations are performed annually or bi-annually as needed.
Close, continued evaluation of the speech, teeth, eyes, and ears are performed on an annual or bi-annual basis as needed. Orthodontic treatment is begun if necessary leading toward final nasal and jaw surgery late in the teenage years.
To read more about cleft lip and palate as well as other craniofacial procedures offered by the surgeons at HNSA, please visit: http://www.plasticsurgery.org/public_education/procedures/CleftLipPalate.cfm.
HNSA’s surgeons are all members of Legacy Emanuel Hospital's Level 1 Trauma Team and have extensive experience managing patients with severe maxillofacial, head and neck injuries. With academic appointments at Oregon Health & Science University, our surgeons are also heavily involved in education and research and have published extensively on the subject of maxillofacial trauma.
The physicians and surgeons at HNSA are uniquely qualified to manage patients with facial injuries, as well as to treat the numerous cosmetic and functional deformities that can occur as a result of complex facial trauma. The face is a complicated structure that provides individuals with their primary sense of esthetic beauty, unique appearance and self esteem. Trauma to the facial region frequently results in injuries to the soft tissue, bony skeleton, jaws, mouth, teeth, lips, nose, eyes and ears. Our physicians are both medical doctors, as well as dentists, and are trained to reconstruct the face and jaws from both a cosmetic and functional standpoint.
Regardless if the injured patient requires primary soft tissue or skeletal repair, bone grafting or soft tissue reconstruction, dental implants to restore lost teeth and occlusion, or facial cosmetic surgery, the surgeons at Head & Neck Surgical Associates will provide the most comprehensive patient care, utilizing the most contemporary techniques and technology available in the world today.
To learn more about the trauma system at Legacy Emanuel Hospital and Health Center, please visit: http://www.legacyhealth.org/body.cfm?id=54&oTopID=0.
Head & Neck Surgical Associates offers comprehensive, state-of-the-art treatment for patients with sleep disordered breathing, including radiofrequency ablation, laser assisted uvulopalatoplasty (LAUP), uvulopalatopharyngoplasty, septoplasty, genioglossal advancement, maxillomandibular advancement and tracheostomy.
Our physicians are part of the first group of surgeons in Portland to offer comprehensive treatment for all types of sleep disordered breathing including snoring and obstructive sleep apnea. Treatment is individualized for each patient depending upon the etiology and severity of the underlying disorder. Often, patients complaining of “snoring” may have underlying medical conditions or severe obstructive sleep apnea that will impact the treatment recommendation. Patients with obstructive sleep apnea that is documented on a sleep study are initially treated with CPAP. Those patients who fail, or cannot tolerate CPAP, are candidates for surgical treatment. Our practice philosophy generally consists of a staged approach in an effort to perform the smallest operation possible in order to achieve a cure.
It is estimated that 40 million Americans snore at some time during their lives. Even more people are affected if you consider the sleeping partners of those who habitually snore. Significant snoring is sometimes so severe that it may be heard more than two bedrooms away.
Snoring is not sleep apnea, and sleep apnea is not snoring. Snoring is a social problem, which may involve considerable sleep disturbance, waking episodes, etc., without obstructive sleep apnea. However, many patients with loud snoring, may also have obstructive sleep apnea.
Treatment decisions are based on whether significant apnea exists. For snorers, treatment can include non-surgical or surgical approaches. Non-surgical options include weight loss and positional changes (keeping snorer off his/her back). Surgical methods include Laser-Assisted Uvulopalatoplasty (LAUP) or radiofrequency ablation treatments.
Obstructive Sleep Apnea Syndrome (OSAS) is characterized by frequent breathing interruptions (airway obstructions) during the night. When breathing stops, there may be a significant decrease in blood oxygen levels and cardiac arrhythmia (irregularities in the heart's normal beating pattern) may occur. In extreme cases, the result can be death. OSAS is a serious disorder, which can become a major health risk. Long-term effects can include both lung and heart problems. On a less drastic level, these disturbances may prevent the brain from entering the restorative REM sleep stage, leading to mood, memory and concentration problems.
Treatment options for patients with OSAS include weight loss, positional changes while sleeping, Continuous Positive Airway Pressure (CPAP), or Uvulopalatopharyngoplasty (UPPP or UP3), septoplasty, or maxillomandibular advancement surgery.
To read more about surgery for snoring and obstructive sleep apnea, please visit http://www.entnet.org/healthinfo/snoring/snoring.cfm .
The surgeons of Head & Neck Surgical Associates have extensive experience with both surgical and non-surgical management of patients with temporomandibular joint (TMJ) disorders, and continue to attract patients from across the country. Treatment generally involves a multidisciplinary approach and includes close consultation with restorative dentists, orthodontists, and physical therapists.
Temporomandibular Joint (TMJ) dysfunction and disorders are related to the complex jaw joint. Symptoms usually come in the form of clicking, popping and pain in the ear and jaw area. Difficulty in eating, tightness and spasm within the muscles of the face are early indications of problems. This may lead to jaw locking and inability to eat without pain. The reason that this area of treatment is so complex is not only is the jaw joint itself a problem, but its intimately connected to the bite. A bad bite or misaligned occlusion tends to complicate the problem. Therefore, there is no simple treatment and/or prescription for your temporomandibular joint problem. Restoring your jaw function to a harmonious and pain free situation is complex and may include several kinds of treatments to restore health and normal function.
Depending upon the particular diagnosis, treatment may involve various medications, diet restrictions, physical therapy, dental splints, orthodontics, and/or surgery.
To learn more about treatment of TMJ disorders, please visit http://www.aaoms.org/pamphlets.cfm.