The London Craniofacial Clinic is a specialist team of Oral, Maxillofacial and Craniofacial surgeons based in the new, central London outpatient centre created by The Harley Street Clinic. They are able to provide a one-stop clinical service to investigate, diagnose and treat a range of conditions of the face, mouth, teeth, jaws, head and neck.
About Us

The Team at The London Craniofacial Clinic include six consultant surgeons who work at one of London’s leading teaching hospitals. From their contemporary west end practice, they offer comprehensive, patient-centred management of conditions affecting the head and neck. They are unique in being able to replicate the standards of care and governance structure seen in their NHS practices.
Surgeons at the London Craniofacial Clinic put patient care at the heart of everything they do. The clinical team provides the full range of Oral and Maxillofacial Surgery services from state-of-the-art facilities at The Harley Street Diagnostic Centre, ensuring patients receive a world-class, efficient and effective service.
The experience of the consultant group, combined with that of the multidisciplinary team, including specialists in Neurosurgery, ENT, Dermatology, Oncology, Radiology, Orthodontics, ensures that patients receive the highest standard of professional care.
“Mr Bentley changed my life and my spirit. Finally, after years of self consciousness about my head, I can look people straight in the eyes without feeling judged.”
Alain E, Cranioplasty Patient











Services

Cervicofacial infection

Common localised infections of this region are usually related to:

  • Dental abscesses/infections and complications related to the extraction of teeth and other oral surgery procedures
  • Tonsillitis
  • Obstructed salivary glands
  • Skin lesions such as sebaceous cysts

Of these, the most common are dental infections.

Causes of dental infections
Dental infections are caused by oral bacteria that leads to dental decay and gum disease that spreads through the apex of the root into the jaw bones where they can form an abscess.

Symptoms of dental infections
An abscess may lead to toothache, mainly caused by pressure on the tooth, although it can initially be symptomless. Often, this is linked to a recent history of dental treatment. If untreated, the infection can spread through the bone into spaces between muscles in the floor of the mouth, neck and the pharynx. This can potentially be very serious and block the airway. Symptoms include pain; swelling; restricted ability to open the mouth; difficulty in swallowing and breathing; and fever and malaise.

Diagnosis and treatment of dental infections
Investigations include radiographs of the teeth and jaws, ultrasound and CT scanning, along with blood tests. Treatment seeks to drain collections of pus via access both inside the mouth and through the neck, together with antibiotic therapy. This is usually carried out under a general anaesthetic; at the same time, the cause of the infection, eg a tooth, is removed.

Other causes
Abscesses linked to tonsillitis (quinsy) usually follow a severe sore throat. They cause swelling at the back of the roof of the mouth and lead to pain and difficulty in swallowing.

Salivary glands can become obstructed and infected when their ducts become blocked by mucus plugs or stones, or by poor salivary flow due to ill health, drugs or radiotherapy.

Skin lesions such as spots and pimples, sebaceous cysts, lacerations and animal and insect bites can also become infected with bacteria that normally colonise the skin. They can also produce abscesses or spreading tissue infections such as cellulitis. Treatment for these involves antibiotics and surgical drainage.

Some patients are more susceptible to infections if their immune system is damaged by HIV or diabetes, or impaired by drugs including steroids, immunosuppressants and chemotherapy.

Cleft lip and palate

Cleft lip and palate (CLP) is a fairly common condition: between 1:500 and 1:1000 children are born with it. In the UK, the incidence is roughly 1:700 live births.

Causes
There are many contributory causes of this condition and often a single one can’t be identified. Factors which increase the risk of CLP are known to include alcohol consumption and smoking during pregnancy, as well as vitamin B12 deficiency.

Clefts can also present as part of a syndrome which includes deformities of other parts of the body and, in some cases, a genetic cause can be identified. In some cases, clefts can be inherited but in the vast majority of cases an inheritance pattern cannot be found. The risk of having children with CLP is only slightly increased if one of the parents has the condition and there is otherwise no family history of the condition. Genetic counselling is widely available in the UK and could certainly be considered when people with CLP plan to start a family.

In patients with CLP facial aesthetics, lip and nose function, as well as speech, are affected. Babies with a cleft palate often have problems with hearing due to glue ear.

To address all these potential problems a team of clinicians is necessary to provide a comprehensive treatment. This team is likely to include an Oral and Maxillofacial or a Facial Plastic Surgeon, an ENT Surgeon, a Speech and Language Therapist, an Orthodontist and a Paediatrician.

Treatment
The primary treatment usually starts with orthodontic treatment for infants, followed by surgery to close the lip and palate defect in the first year of life. Surgery to fill the bony defect of the tooth-bearing part of the upper jaw can be expected at the age of eight to ten years. Further corrective surgery may be necessary in the teens.

Craniofacial surgery

This branch of surgery concentrates on conditions of the head leading to deformity.

Children
In children, this relates to the diagnosis and treatment of infants with misshapen heads. This is either as the result of pressure early in life or so called ‘positional plagiocephaly’, moderate to severe cases of which may require corrective helmet therapy and physiotherapy.
More rarely, early closure of the skull sutures leads to craniosynostosis, which may require a multidisciplinary team to perform corrective surgery to improve the severely affected head shape. This procedure may be performed on babies as well as infants.

Adults
In adults, head deformities are more often related to defects that result from neurosurgical procedures to relieve pressure on the brain following trauma or stroke. Such defects, or craniectomies, leave patients with large skull deformities and with symptoms of headaches, tenderness and a fear of further injury that necessitates the wearing of a protective helmet. Custom made titanium metal implants utilising computer technology are now used to reconstruct the defects, thus avoiding the need to wear a protective helmet and alleviating pain and often improving speech and language function.

Other more complex defects which have involved loss of skin, muscle and bone after cancer surgery can be restored with implants used to support prostheses such as the eye socket contents or ear.

Craniofacial trauma

Patients involved in falls, assaults or road traffic collisions often suffer facial injuries affecting the soft tissues, the teeth and the bones of the face including the jaws, cheek bones, eye sockets, nose and skull.

These complex injuries require accurate and prompt assessment by an oral and maxillofacial surgeon specialising in facial injury to ensure the correct diagnosis and the subsequent treatment of all aspects of the injury. This is essential to ensure that the underlying fixation of the bones and closure of soft tissue injuries results in the return of normal appearance and function; only by working closely with other specialists, such as eye surgeons and neurosurgeons, can these objectives be achieved.

Many patients receive less than ideal treatment in the first instance and much of our work relates to the secondary correction of trauma-associated deformity, ranging from scar revision and corrective bone surgery, to addressing problems with appearance or problems with vision or chewing.

State-of-the-art computer aided planning and multidisciplinary team work ensures the best possible results are achieved for patients who are quite naturally very sensitive about their facial appearance.

Dentoalveolar surgery

Dentoalveolar surgery is the surgical treatment of disorders of the teeth and their supporting hard and soft tissues.

Surgical removal of teeth – seriously decayed or broken teeth may require referral to a specialist in oral and maxillofacial surgery for removal. Patients may also require referral because their medical history can make tooth removal by a dentist more complicated, eg anticoagulation or previous treatment with bisphosphonates.

Removal of impacted or ectopic teeth – teeth which have developed out of their normal position or lie at an unusual angle in the jaw can be considered impacted and/or ectopic. Removal of these teeth is often not straightforward. Wisdom teeth and canine teeth are the most commonly impacted/ectopic teeth requiring surgical removal.

Removal of developmental abnormalities of the teeth and jaws ─ these conditions include the development of extra (supernumerary) teeth and malformed teeth known as odontomes. Jaw bone abnormalities can include areas of additional bone formation (bony exostoses or tori) and abnormalities in bone development such as fibrous dysplasia.

Removal of benign cysts of the jaw – a cyst is a pathological cavity within the jaws. There are several different types of jaw cysts. Treatment is usually surgical but is dependent on the actual type, site and size of cyst. Referral to a specialist in oral and maxillofacial surgery is required for diagnosis and appropriate treatment.

Removal of benign tumours – this involves the surgical management of non-malignant tumours of the jaws and soft tissues.

Pre-orthodontic surgery – in addition to the removal of impacted or ectopic teeth, which can interfere with the alignment of teeth when braces are used, ectopic or buried teeth can be uncovered by removing the overlying bone and gum tissue. The tooth can then be brought into a normal position using an orthodontic appliance. This is a common procedure for canine teeth in the upper jaw.

Pre-prosthetic surgery – this refers to procedures facilitating the construction and optimum function of dentures. It can involve repositioning of the mucosal tissue to allow dentures to fit better or the placement of bone grafts to build up deficient areas of jaw bone.

Dental implants – these are threaded titanium fixtures which can be placed into the jaws where teeth are absent in order to support an overlying crown, bridge or denture. Treatment is multidisciplinary and will be provided by a team comprised of oral and maxillofacial surgeons and restorative dentists. Preparatory bone grafting to the jaws or sinuses (the air cavities within the posterior part of the upper jaw) is often required to create enough bone within which to place the implants.

Facial deformity and orthognathic surgery

Orthognathic surgery is literally surgery to straighten jaws.

Orthognathic surgery corrects the position of the jaws. It is usually carried out at the same time as orthodontic treatment to correct the position of the teeth. Orthognathic surgery not only corrects the alignment of the jaws, but also ensures that the teeth meet correctly. This can improve how the jaw works and a patient’s dental health, as well as their facial appearance.

When is orthognathic surgery needed?

  • When there is jaw discrepancy, eg large or small lower jaw, or small upper jaw
  • The patient has a ‘long face’ which may present with a gummy smile
  • The patient has a ‘short face’ which may present with no teeth showing or with a deep bite which may cause trauma to the gums and teeth
  • The patient has an asymmetrical face and jaw
  • The patient has an ‘open bite’ where the front teeth of the upper and lower jaws don’t meet

Orthognathic surgery is sometimes needed to help treat sleep apnoea and post traumatic facial deformity after an injury to the bones of the face.

Treatment is usually carried out using a multidisciplinary approach with an orthodontist. Most cases start with the orthodontic treatment followed by surgery, often 18 months later. Surgery is carried out under general anaesthetic.
Chin surgery (genioplasty) may also be performed as part of the overall orthognathic surgery treatment, but it can also be used in isolation. It can correct asymmetry of the chin and address chins that are too small, too long or too prominent. This surgery is performed inside the mouth.

Facial plastic surgery

Facial plastic surgery is surgery to change the function or appearance of the face. All these procedures are available at the clinic. Maxillofacial surgeons are trained to assess not only the soft tissues but also the bones of the face and jaw. Sometimes the foundations of the face need to be treated before the superficial skin.

Brow lift
This is surgery to improve the position of the eyebrows and forehead. It is common for people to think that they need surgery to their upper eyelids when they actually need a brow lift. Only when the brow is in the correct position should the upper eyelids be assessed for surgery.

Blepharoplasty
This is surgery to the eyelids. With time the skin and underlying muscles of the eyelids becomes lax and can allow the fat within the eye socket to bulge, causing eye-bags.

Facelift
This procedure reverses the natural effects of gravity on the skin and deeper tissues of the face. It is a good way to re-define the jawline and smooth the large skin creases of the face.

Rhinoplasty
Click for more detailed information.

Head and neck lumps

The London Craniofacial Clinic is a one-stop clinic where a patient can be seen by doctors from different specialities to investigate, diagnose and treat the cause of swellings in the head and neck.

The anatomy of this region is complicated with multiple organs, blood vessels, nerves and lymphatic structures packed into a relatively small area. Enlargement of individual tissues may represent either normal physiology or pathology of multiple causes. Diagnosis really depends on identifying which structure is involved and why it is enlarged.

A patient with a neck lump will usually be examined on the same day by an Oral and Maxillofacial surgeon, a Haematologist, a Radiologist and a Cytopathologist. Initially, a complete clinical history of the neck lump will be taken. The area will then be examined, together with any other parts of the body that may be related to the lump. This may involve a nasendoscopic examination of the pharynx and larynx and a local anaesthetic. The area will then be imaged, usually with ultrasound scanning. If needed, a biopsy of the lump can be obtained using a fine needle aspiration technique. A Cytopathologist will then examine this specimen under a microscope and, in some cases, a diagnosis can be made at the same clinic visit.

If a diagnosis is not possible at this stage, further imaging of the area, using either CT or MRI scanning can be arranged, together with other parts of the body if necessary. Blood tests may be required. In some cases it may be necessary to organise a further biopsy or surgical removal of the lump, which will require surgery as day case or inpatient.

Enlargement of one or more cervical lymph nodes, which form part of the body’s immune system, is the commonest cause of a neck lump. This may be due to multiple factors including infections, inflammatory conditions, drug reactions and some forms of cancer.

Implantology

Dental implantology
Dental implants are small metal devices which are roughly the shape of a wide screw and serve as artificial roots to replace lost teeth. They are usually made of 100% titanium. They are screwed into the jaws to be connected later to artificial teeth. As far as medical science is aware, these devices do not pose any long term health risks. Experience with dental implants goes back several decades and, generally, long term results are excellent.
Not every dental gap is best restored with the use of these implants and sometimes conventional solutions with a bridge can be aesthetically advantageous.

When teeth are lost, the bone in the area tends to reduce and it can be necessary to build up the bone again before the implants can be inserted. The best results of bone augmentation can be achieved by using the patient’s own bone. This is usually harvested from the hip (the ‘Gold Standard’) or, if the amount of extra bone needed is relatively modest, from a bone bank. Alternatively, artificial materials can be used.

Once the implants have been inserted and are well healed in, they can be ‘loaded’ with artificial teeth which are either screwed or cemented onto the implant at gum level.

In complex cases it can take a year from bone augmentation surgery to having new teeth in the mouth, but in most cases the treatment period is much shorter.

Oral medicine

Oral and maxillofacial medicine
We manage patients with conditions involving the oral and perioral structures, (eg lips, mouth, tongue and mucosa) as well as those with oral manifestations of systemic diseases.
The types of condition we treat include:

  • Mouth ulcers, including aphthous ulcers
  • Red, white and pigmented lesions around the mouth
  • Lumps and swelling within the mouth
  • Oral lichen planus
  • Temperomandibular joint pain dysfunction – also known as TMJ disorders
  • Oral fungal/candidial infections
  • Dry mouth
  • Facial pain
  • The oral manifestations, (eg trigeminal or other neuralgia) of systemic diseases such as anaemia, Crohn’s disease and ulcerative colitis. These problems may require further investigations (including blood tests, a biopsy of the lesion or imaging) and lead to, or exclude, a medical diagnosis which may require referral to a specialist in a different field

Photodynamic Therapy

Photodynamic therapy (PDT) involves the use of a photosensitising agent that becomes activated by light to create reactive oxygen molecules that will destroy nearby cells. It is a topical treatment, and is able to treat thin skin cancer (basal cell carcinomas) and precancerous lesions such as actinic keratosis and Bowen’s disease (intra-epidermal squamous cell carcinoma). There is A1 evidence for the use of PDT in Bowen’s disease and superficial basal cell carcinomas. It has also been used in non-skin cancer conditions, including acne and facial rejuvenation.

The treatment involves three steps:

  1. Administration of drug/photosensitiser
  2. Incubation time to allow the best selectivity of photosensitiser between the normal and abnormal cells
  3. Light activation

The main advantages of PDT are the relative selectivity in treatment of the abnormal tissue and the excellent cosmetic outcome. What’s more, large areas of disease can be treated with this method. There is also no maximum dose and no cumulative toxicity, so patients can have more treatment in the future should further lesions occur. PDT is a safe and effective treatment in the treatment of superficial basal cell carcinomas, Bowen’s disease and actinic keratosis.

Rhinoplasty

Corrective rhinoplasty can be necessary for functional or aesthetic reasons. Most people have a certain degree of septum deformity which can block the nasal airway and lead to a reduced airflow or blocked nose if it is severe enough. If the septum is curved it needs to be straightened surgically to improve nasal function (septoplasty).

However, a reduced nasal airflow can also be caused by a simple swelling of the nasal lining due to increased irritability caused by hayfever or a house dust allergy and this should not be treated by surgery but with anti-inflammatory medication and avoidance of the irritant. Therefore, a thorough examination prior to potential surgery is important to check for the underlying cause.

When it comes to rhinoplasty for aesthetic reasons, personal taste plays an important role. Patients and Rhinosurgeons should discuss in detail, and possibly with the help of photographs, what needs to be changed and achieved by surgery. There is not just one nose shape which fits every face and therefore the intended changes should suit the face of the individual patient. As a general rule, the aim of any rhinoplasty should be to take the attention away from the nose and lead it towards the person’s eyes.

Salivary gland disease

Saliva is essential for speech and swallowing and plays an important role in oral health by maintaining the integrity of the oral mucosa. It also has a role in controlling dental decay and periodontal disease through its antibacterial and acid buffering properties.

Saliva is produced by three pairs of major salivary glands:

  • The parotid glands
  • The submandibular glands
  • The sublingual glands

In addition, there are hundreds of other minor salivary glands distributed widely just beneath the mucosa lining of the mouth, the hard and soft palate, cheeks, lips and the floor of mouth.

Causes of salivary gland disease
Most salivary gland problems are due to infections (acute and chronic); obstruction from stones/mucous plugs; benign and malignant tumours; and destructive autoimmune diseases.

Infections – mumps is the most common cause of viral salivary gland infection. Bacterial infection of the major glands usually arises from the mouth and is often a recurrent problem, especially in a gland previously damaged by stones or radiotherapy or in debilitated patients. An increasing variety of salivary gland disorders are being seen in HIV positive patients. Specialist knowledge of dental and oral diseases is necessary for the proper management of these patients.

Obstructions – calculi or stones can form in the major salivary glands (most commonly in the submandibular glands) and their ducts. They cause obstruction of salivary outflow causing pain and swelling, typically at meal times. If the obstruction is not relieved the gland can be damaged and may require surgical removal. Calculi can be removed surgically, endoscopically (if small enough) and occasionally using lithotripsy (shockwave therapy). Obstruction of minor salivary glands also occurs and results in cyst like swellings of the lips and cheeks (mucocoeles).

Tumours – a large variety of both benign and malignant tumours can involve any of the major or minor salivary glands. Although the vast majority are benign, they grow continuously and can reach a large size. Malignant tumours of the salivary glands are rare. The management of salivary gland tumours requires specialised surgical skills due to the proximity of important cranial nerves and the often aggressive nature of malignant disease. Patients with malignant disease should be managed via a multidisciplinary head and neck oncology clinic.

Degenerative disease – the salivary and lacrimal glands can be affected by an auto-immune, destructive condition called Sjögren’s syndrome which results in dry eyes and a dry mouth. Sjögren’s syndrome is often associated with other systemic diseases such as rheumatoid arthritis and lupus erythematosus. Patients develop severe oral and eye symptoms relating to failure of saliva and tear production. Approximately 10% of patients with Sjögren’s syndrome will go on to develop a non-Hodgkin’s lymphoma. These patients require meticulous follow-up in order to detect the onset of lymphoma at an early stage.

Skin cancer

Benign skin conditions
Bowen’s disease
Bowen’s disease is a very early form of squamous cell carcinoma (SCC). This looks like a red scaly patch on the skin. It may remain unchanged for years. In 3-5% of patients, Bowen’s disease invades the deeper layers of skin and becomes a skin cancer. There are several ways of treating this condition. If a patient requires surgery, the patch of affected skin is cut out and closed with stitches.

Solar keratosis
Solar or actinic keratoses are dry scaly patches of skin caused by long term exposure to sunlight. They range in colour from pink, red or brown. The skin can become very thick and produce horns or spikes. Around a quarter of the UK population aged over 60 years old are thought to have solar keratosis. It is estimated that over a 10 year period, 10% to 20% will transform into a squamous cell carcinoma (SCC). There are several treatments for this condition. Surgery is used to remove the lesion and this allows the pathologist to make a diagnosis in the laboratory.

Keratoacanthoma
This is a fast growing lesion that resembles a squamous cell carcinoma (SCC). It is probably best considered as a non-aggressive form of SCC. The treatment is surgical removal to allow it to be examined under a microscope to see if it is a SCC. Removal will usually cure it.

Of the three main types of skin cancer: Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) and melanoma, it is estimated that for every 100 BCC cases there will be 10 SCC and one melanoma. Skin cancers are divided into non-melanotic and melanotic because the treatment for BCC and SCC are similar compared to melanomas.

Basal cell carcinoma or ‘rodent ulcers’
BCCs are the most common form of skin cancer and, in fact, they are also the most common form of cancer. Caused by long term exposure to sunlight, they tend to form on sun exposed areas of the body. Around 80% occur on the head and neck region. BCCs do not spread around the body, but if left untreated will continue to grow and will invade deeper tissues such as cartilage and bone.

There are several forms of treatment. If surgery is the most appropriate treatment, this has the advantage of removing the whole lesion and sending it to the pathologist. This allows identification of the type of tumour and ensures that it is completely removed.

Squamous Cell Carcinoma
SCC is the second most common skin cancer type. The number of SCCs in the UK is increasing. The incidence increases with age and is twice as common in men as women. SCC can grow rapidly and metastasize. They are caused by prolonged exposure to sunlight causing mutations in the keratinocyte cells of the skin. These can also develop in pre-malignant conditions such as actinic keratosis or Bowen’s disease and in people who are immune-compromised, such as transplant recipients taking immune-suppressant drugs. Surgical treatment means cutting out the lesion with a safety margin of normal tissue all around. This is to ensure that all the cancer has been removed at a microscopic level.

Melanoma
Melanoma and malignant melanoma are one and the same. The two terms are used for the same condition, but as there are no benign melanomas the term melanoma is now preferred. There are four types of melanoma: lentigo maligna melanoma, superficial spreading, nodular, and acral. The tumour arises in melanocytes, the cell that produces the pigment melanin that helps determine the skin’s colour. The number of people developing melanoma is increasing. One of the main causes is sunlight (ultraviolet radiation). The increase in the number of holidays taken in sunny countries and the use of sunbeds are contributing to this trend.
Although melanomas can start in a mole, the majority start in normal skin. The ABCD checklist shows the features that we look for that may indicate that a melanoma is forming.

A for Asymmetry – normal moles are usually symmetrical. Melanomas tend to be irregular in shape.
B for Border – a smooth, well-defined border is more in keeping with a benign mole. A ragged edge that is not smooth is a sign of melanoma.
C for Colour – moles are uniformly brown in colour. Melanomas are multi-coloured (variegate). This can be very black to red, white and blue.
D for Diameter – moles do not usually get bigger than a pencil eraser width (6mm in diameter). Melanomas are usually bigger than this.

Oral surgery

Common localised infections of this region are usually related to:

  • Dental abscesses/infections and complications related to the extraction of teeth and other oral surgery procedures
  • Tonsillitis
  • Obstructed salivary glands
  • Skin lesions such as sebaceous cysts

Of these, the most common are dental infections.

Causes of dental infections
Dental infections are caused by oral bacteria, which cause dental decay and gum disease, spreading through the apex of the root into the jaw bones where they can form an abscess. This may lead to toothache, particularly due to pressure on the tooth, although it can initially be symptomless. Often, there is a history of recent dental treatment. If untreated, the infection can spread through the bone into spaces between muscles in the floor of the mouth and neck and the pharynx. These can be potentially very serious and compromise the airway.

Symptoms of dental infections
These include pain, swelling, restricted ability to open the mouth; difficulty in swallowing and breathing; and fever and malaise.

Diagnosis and treatment of dental infections
Investigations include radiographs of the teeth and jaws, ultrasound and CT scanning, along with blood tests. Treatment seeks to drain collections of pus via access both inside the mouth and through the neck, together with antibiotic therapy. This is usually carried out under a general anaesthetic; at the same time, the cause of the infection, eg a tooth, is removed.

Other causes
Abscesses related to tonsillitis (quinsy) usually follow a severe sore throat. They cause swelling at the back of the roof of the mouth and lead to pain and difficulty in swallowing. Salivary glands can become obstructed and infected as their ducts become blocked by mucus plugs or stones, or by poor salivary flow due to ill health, drugs or radiotherapy.

Skin lesions such as spots and pimples, sebaceous cysts, lacerations and animal and insect bites can also become infected with bacteria that normally colonise the skin. They can also produce abscesses (boils and furuncles) or spreading tissue infections called cellulitis. Again, treatment involves a combination of antibiotics and surgical drainage.

Some patients are more susceptible to infections if their immune system is damaged by diseases such as HIV and diabetes, or impaired by drugs including steroids, immunosuppressants and chemotherapy.

Skull base surgery

Patients who unfortunately suffer from tumours that affect the base of the skull often present to our Neurosurgical colleagues for treatment. These tumours although often benign are often involve the back of the eye socket leading to visual problems such as reduced vision, double vision or protrusion of the eye. These tumours such as skull base meningiomas are rare and slow growing but can cause significant cosmetic and eye problems.

It is recognised that the best results of treatment of such conditions are best achieved as part of a multidisciplinary team approach involving Neuro, Craniofacial and Opthalmic surgeons allowing the best access to remove the tumour in the most cosmetically sensitive way leaving the patient little or no facial deformity.

Complex reconstructions allow for rehabilitation where possible allowing preservation of vision and return to normal appearance.

Furthermore by planning the surgery with our Radiotherapy colleagues the best chances of disease control can be achieved long term. Such Skull Base teams are rare and confined to specialist centres like King’s College Hospital but we are pleased to be able to offer the same at Harley Street Clinic.





Man with half a head undergoes surgical reconstruction


28 May 2014

Tim Barter, who lost parts of his skull after falling from a roof, has received surgical reconstruction, the first procedure of its kind in the UK.

Read the full story