Integrating Advanced Practice Practitioners in Pediatric Head and Neck/Craniofacial Surgery: Lessons Learned, Opportunities, and Enhanced Clinical Care

PURPOSE: Advanced practice practitioners (APPs), including nurse practitioners and physician assistants, are increasingly being integrated into pediatric surgical subspecialties. In pediatric head and neck surgery (PHNS), the complexity of congenital anomalies, airway disorders, and oncologic conditions necessitates multidisciplinary, longitudinal, and coordinated care. Despite this, guidance on the structured training and integration of APPs within PHNS is nonexistent. METHODS: This narrative review and expert opinion articles synthesize what exists in the literature on APP utilization in surgical subspecialties and integrate the clinical experience at a high-volume pediatric head and neck surgery and craniofacial program. Key domains examined include education and training, operative room integration, clinical care coordination, outpatient and inpatient clinical care, and program development. RESULTS: Well-trained and fully integrated APPs enhance operative flow, continuity of care, clinical efficiency, and clinical outcomes. APPs play a central role in postoperative clinical care, inpatient care, and multidisciplinary program development. Progressive autonomy, supported by clearly defined clinical care pathways and surgeon mentorship, is essential for integration. CONCLUSION: APPs are essential members of a PHNS team. A structured, mentorship-based approach to training and integration supports high-volume, patient-centered care while improving efficiency and programmatic growth. More studies are needed to evaluate the impact on patient satisfaction, financial impact, and clinical outcomes associated with APP integration into PHNS.