Three UCF medical students, who researched better ways to help children with cleft palates and other skull deformities, recently presented their findings to international scientific experts.
They credit the College of Medicine’s required research module and their mentor, an Orlando pediatric plastic surgeon, with inspiring them to seek new knowledge that will help patients in the future.
Fourth-year medical student Hannah Brown, and third-years Leticia Lenkiu and Rose Meltzer presented their research at the biennial International Society of Craniofacial Surgeons (ISCFS) in Shanghai. The society is comprised of surgical leaders from 30 countries worldwide and it focuses on plastic and reconstructive surgeries that correct congenital malformations of the face, jaw, neck and skull.
It marks the first time UCF students have presented at the conference, and it is rare for student researchers of any university to receive an invitation to participate at this level, said Dr. Raj Sawh-Martinez, chief of pediatric plastic surgery at AdventHealth for Children and the students’ mentor
“From a career standpoint, you’re on the ultimate stage trying to demonstrate your work,” he said. “Their growth has just been astronomical, and I’m incredibly impressed that they put things together so well. I’ve known them since they started as first-year medical students. They came in learning the basics about medicine, but they were eager to learn the nuances and complexities of craniofacial surgery.”
The students’ research began during their Focused Inquiry and Research Experience (FIRE) module, which requires every UCF med student to complete a two-year scientific study to advance medical knowledge. Some students continue their projects throughout all four years of medical school.
The three students worked with collaborators at the College of Medicine and AdventHealth for Children.
A “Passion Project” To Help Children
Brown has spent the last four years studying whether robotic surgery can be a more efficient and effective way to repair a child’s cleft lip and palate.
After connecting with Dr. Sawh-Martinez, Brown learned that while robotic surgery is excelling in other areas of medicine, it wasn’t used for plastic and reconstructive surgery.
“Robotic surgery has just been introduced for microsurgery and delicate tissues in the US, and so I wanted to see how it could do with cleft surgery,” she said.
She concluded that these microsurgical robots lack the physical strength to do some portions of the cleft surgery and took longer than procedures done by a doctor’s hands alone. But robotic surgery also offered benefits, including improved precision, visualization, ergonomics and better surgery site handling during the delicate portions of the surgery. Brown’s findings provide a foundation for further research on how to make robotics clinically relevant for cleft surgeries.
“This was exciting because it really is a passion project,” Brown said. “You put in so many hours into something that might not even work and you’re just taking a leap of faith to test a hypothesis. I’m really glad to have had the space to grow, and that UCF offers FIRE to engage students in research.”
High-Tech Imaging to Improve Pediatric Surgery
Lenkiu’s projects also examined emerging technologies to enhance pediatric care.
She and her collaborators studied using interoperative MRI (iMRI), 3D modeling and augmented reality to improve a surgeon’s ability to visualize and plan specialized cleft palate surgery. The iMRI creates real-time images during surgery and is used frequently in brain surgery to help guide doctors as they remove tumors and surgically treat epilepsy.
The iMRI is already used in older cleft patients, but Lenkiu’s project scaled the technology for use in infants and proved it could be a viable resource, Dr. Sawh-Martinez said.
“This is really the first time we’ve objectively analyzed cleft palate anatomy immediately before and after surgery this thoroughly,” he said. “We looked at the tiny muscles before and after the repairs, and we saw that we could adjust our approaches as we got to understand the anatomy much better. [Lenkiu’s] research got some of the biggest applause because I think this was the first time we’re seeing those objective outcomes in babies at the time of their cleft repairs.”
A Better Surgical Approach for Cranial Compression
Meltzer’s research project focused on surgery for craniosynostosis, a birth defect where a baby’s skull bones fuse too early, before the brain stops growing. This condition can cause the child’s head to be abnormally shaped and place increased pressure on the brain. Children with the condition usually require surgery – either directly into the skull or a less invasive endoscopic procedure.
Meltzer’s hypothesis: What if combining the two surgeries would better help the infant’s brain and skull develop correctly?
“We were looking at starting with the early endoscopic surgery and then following up with an open approach that slowly expands the skull,” Meltzer said. “The hope is that this will result in better outcomes for these patients with very severe cases of restriction, where many of the skull growth plates are stuck together.”
Their analysis found that the two-part surgery was feasible and safe, but they recommend further research for long term outcomes.
“This has been an ongoing debate on how to approach these kinds of surgeries,” Dr. Sawh-Martinez said. “It has always been one or the other, but we thought that those children with severe cases would benefit from a more comprehensive approach.”
Brown, Lenkiu and Dr. Sawh-Martinez attended the conference. Dr. Sawh-Martinez presented Meltzer’s work.
A Real-World Research Experience
Lenkiu says she grew as a medical scientist through Dr. Sawh-Martinez’s support and the experience of presenting her research at a high-level conference.
“It took a lot to feel comfortable going on stage and sharing your work with people who know it better than anyone,” she said. “It greatly impacted my confidence, not just as a student and future doctor, but also as someone who is actively contributing to the broader science. It’s such a specialized conference, and to be included in the conversation is humbling.”
Dr. Sawh-Martinez praised UCF’s research-based curriculum and said the FIRE experience is helping train better doctors for the future.
“We’re learning about science, sure,” he said of the research experience. “But we’re learning how to develop as leaders and how to accomplish a goal as a team.”
The students said their bond through research and mentoring has made a lasting impact.
“They’re really some of my best friends,” Lenkiu said. “And this research group, it’s not just about research, it has quite literally like molded my entire medical school experience. We do almost everything together. We teach each other and together we even help mentor the next generation.”