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une Wu performs surgery in China.
June Wu performs surgery in China.
Bread and butter surgery,” is how June Wu, M.D., assistant professor of surgery, describes the cleft lip and palate surgeries she performed during her first medical mission to China recently. But what is routine for Dr. Wu has turned out to be life-changing for two of her young patients in Xian, who are in the process of being adopted from the orphanage in which they live.
   “We treat the most disadvantaged segment of society – the babies and children who can’t advocate for themselves,” Dr. Wu says. “This operation gives them a better chance of being adopted, or at the very least improves their appearance so they can integrate into society.”
   Dr. Wu, P&S’96, went to China this past May when Jeffrey Ascherman, M.D., associate professor of clinical surgery and director of the Cleft/Craniofacial Center at CUMC, was unable to make what would have been his seventh overseas medical mission. “I wasn’t originally supposed to be the physician going on this mission, but the experience sold me on the idea of going on more of them,” Dr. Wu says.
   Conditions in China were challenging. Children with cleft lip or palate are often more severely disfigured there than in the United States, because their problem has often been neglected. A child born with a severe cleft lip and palate in the United States may be fitted within a few weeks after birth with a retainer that slowly forces the two sides of the palate together. By the time surgery is performed, when the baby is between 3 to 6 months old, the sides are in a more normal position. This reduces the size of the cleft and makes the operation somewhat less difficult. It also reduces the chances that the repair will pull apart after surgery, and improves facial aesthetics. But on her trip Dr. Wu saw children as old as two, whose clefts, without treatment, had continuously enlarged.
   These were trying conditions for any surgeon, but particularly for one who is accustomed to spending an hour at the beginning of an operation painstakingly delineating her surgical plan – the blueprint for the operation – on a patient’s face. “I suppose I’m a bit of a perfectionist,” she says.
   Dr. Wu also has an artistic sensibility that infused her choice of medical specialty. “I knew in my first year of medical school that I wanted to be a plastic surgeon. I like plastic surgery because it’s not just technical, there’s an artistic component,” she says.
   After medical school, Dr. Wu completed an integrated general and plastic surgery residency at Montefiore and was drawn to pediatric craniofacial surgery.
   “Plastic surgery is often associated with adults trying to achieve a flawless appearance,” Dr. Wu says. “But for children, plastic surgery often helps a child look more average. In many cases, children would be shunned and never able to function normally in society without surgery. Surgery puts them on a level playing field and also relieves the heavy emotional toll on the family.”
   After finishing her fellowships in craniofacial surgery and vascular anomalies at Children’s Hospital of Boston, Dr. Wu was recruited to Columbia by Dr. Ascherman two years ago.
“I’ve known June since she was a medical student, and when we started expanding the pediatric surgery program, I knew she would be a wonderful addition,” Dr. Ascherman says. “June is very committed to children, and since she began, she’s been a very important part of our team.”
   Dr. Wu is already planning to return to China next year, both to treat children and help her Chinese colleagues learn the latest surgical techniques.
   “The trip was definitely a learning experience for me,” Dr. Wu says. “The conditions are very different and challenging, but the work is extremely rewarding. I’m very much looking forward to going back.”

—Susan Conova

Center’s Team Approach Ensures Best Results for Cleft Lip and Palate Defects

For the approximately 1 in 700 children born with cleft lip or palate in the United States, a team of specialists is often required to repair the defect and obtain the best possible outcome. Since such children usually speak with nasal intonations that may be hard to understand, speech therapists usually begin working with the child as soon as he or she begins to speak. Otolaryngologists manage the frequent ear infections many children experience because of malfunctioning Eustachian tubes. And oral surgeons graft bone into the gumline when bone is lacking, to hold the child’s permanent teeth in place as they grow in.
  The Cleft/Craniofacial Center at CUMC coordinates such care among all specialists. The center was created in 1994 by Jeffrey Ascherman, M.D., associate professor of clinical surgery and the center’s director. Since then, center physicians have treated hundreds of children with cleft lip/palate and other craniofacial abnormalities.