Hospital de Santa Maria-Centro Hospitalar Lisboa Norte (CHLN) is the largest university hospital In Portugal and it is part of the Lisbon Academic Medical Centre, which also includes the Lisbon medical school (Faculdade de Medicina de Lisboa) and a research Institute (lnstituto de Medicina Molecular - iMM), promoting the interaction between clinicians and scientists.

The Craniofacial Team at Hospital de Santa Maria-CHLN has been treating patients with craniofacial malformations for many decades, and in an integrated form for the last 17 years, particularly children with syndromic and nonsyndromic craniosynostosis, referenced from hospitals, health care centres, family doctors and pediatricians across the country. Our multidisciplinary team includes Neurosurgeons and Plastic Surgeons (with specific training obtained at international reference centres), orthodontists, anesthesiologists with training In pediatric anesthesiology, experienced intensive care unit pediatricians, pediatric surgeons, pediatricians (including pulmonologists and neurologists), ophtalmologlsts with specific training in pediatric neurophtalmology, radiologists with experience in pediatric imaging, clinical geneticists, pediatric psychiatrists and psychologists and a dedicated nursing team.

The centre treats an average of 20 new cases of craniosynostosis per year, which corresponds to around 50% of the new cases diagnosed in Portugal every year, complying with the guidelines of the International Society of Craniofaclal Surgery. Our results are comparable to those reported from internationally renowned centres including absence of mortality or neurological deficits, low infection rate (<1%) and the ability to treat childrenfrom the neonatal period to adulthood, using innovative techniques including skull expansion with springs, facial distraction and endoscopic procedures. We have a weekly clinic to follow up patients with craniofacial malformations. In our pediatric neurosurgery clinic we have on average 1400 appointments a year.

Cleft patients have been treated at the Lisbon University Santa Maria Hospital since 1956. Multidisciplinary team work for cleft patients began in 1988. The Cleft patients team still meets monthly, bringing their specific expertise. The team is made up of plastic surgeons, specialists in facial orthopaedics and orthodontics, pediatricians, ENR specialists, phoniatricians and logopedists, psychiatrists and psychologists, social workers and pediatric nurses.

The team offers fellowships in pediatric neurosurgery and craniofacial surgery, and teaching for medical students, residents and pediatricians. Over the years we have trained several residents (mainly Neurosurgery and Plastic Surgery residents) and specialists (Pediatricians and Neurologists) from main hospitals across the country who seek for specialized training. Team members participate in the European Society of Craniofacial Surgery, the International Society of Craniofacial Surgery, the European Association of Neurological Societies, the European Society for Pediatric Neurosurgery and the International Federation of Neuroendoscopy, the European Federation of Oral Surgery Societies, European Orthodontic Societies and Eurocleft project. The expertise of our team in patient care, education and training will contribute to the care of patients with rare craniofacial disorders.