For 25 years, our group, comprising the specialities of craniofacial and plastic surgery, and paediatric neurosurgery, has been dealing with craniofacial anomalies.
Craniofacial surgery is especially involved with treating congenital craniofacial anomalies.
The first group is represented by craniosynostosis or craniostenosis, in which the cranial sutures are prematurely fused, distorting the cranial vault (oxycephaly, trigonocephaly, brachycephaly, plagiocephaly) and faciocraniosynostosis, with facial retrusion (Crouzon, Apert, Pfeiffer, and Saethre-Chozten syndromes). Facial and monobloc distraction is often used for these patients.
Since 1992, the pediatricians having recommended to keep the infants from 0 to 6 months, laying on their back, the number of posterior cranial deformations at the wendensly increased. These deformations are positionnal, not synostototic, and can be easily treated (cf chapter “Positional deformities”).
Another group of craniofacial anomalies is represented by facial clefts with hypertelorism, nasal anomalies, palpebral colobomata, encephaloceles, and Treacher-Collins syndrome. Many of these syndromes require complex orbital surgeries, for orbital dystopia. For example, bringing the orbits together in hypertelorism (widely-spaced orbits) requires complete orbital mobilization, such as in transcranial or subcranial facial bipartition.
Progressive craniofacial anomalies like neurofibromatosis (Recklinghausen disease) and fibrous dysplasia require complex treatments.
Craniofacial techniques are also used for treatment of orbitofrontal fractures and for post-traumatic sequelae, especially malar and ethmoidal fractures.