At birth, some unfortunate infants present a significant anomaly of the shape of the skull and/or the face.
Though clefts of the lip and palate have been treated for a long time, not much was done for the distortions and asymmetries of the skull, the forehead, the orbits..
To treat these conditions, Paul Tessier, a plastic surgeon from Paris, France, devised a completely new approach that he called « Craniofacial Surgery ».
The fundamental principle is to reposition all the displaced parts of the skull in their normal position, like one does for the skeleton of the lower or upper limbs, and to replace the missing parts with bone grafts.
To correct the orbital and frontal anomalies, cooperation with the neurosurgeon is essential, and it was Paul Tessier who persuaded Gerard Guiot, a neurosurgeon working in the same hospital as he, Hôpital Foch, to start this pioneer team work in the Sixties..
These principles were applied firstly to facial advancement for facial retrusions and for orbital mobilization, to correct hypertelorism (excess width between orbits) and orbital dystopia (orbits not at the same level).
Later, the same principles were applied to correct a series of various congenital malformations : craniosynostosis, lateral facial clefts, encephalocele, neurofibromatosis, and also, to correct post-traumatic deformities and to reconstruct after tumor removal.
New developments are the distraction principle, introduced in craniofacial surgery by Joseph McCarthy
from New York ; distraction is a slow progressive displacement of bone, guided by an apparatus,
which allows repositioning in the desired position and new bone formation.
The development of microplate systems, now absorbable if desired, permits an easier fixation..
The new imaging techniques have also helped tremendously the better understanding and treatment of craniofacial anomalies.
Genetic analysis has shown that many of these conditions are transmitted from parents to children and it becomes possible to evaluate the risk of transmission and determine if a foetus is affected. The foetal ultrasound also enables to determine early on if there is a craniofacial anomaly.
Daniel Marchac, Plastic Surgeon, trained with Paul Tessier, and in 1976, he organized a craniofacial team with Dominique Renier, Pediatric Neurosurgeon, at the Hôpital Necker-Enfants Malades. Together, they have treated a considerable number of patients, in particular, for craniosynostosis and faciocraniosynostosis, as well as facial clefts and hypertelorism.
The operations are performed In Hôpital Necker Enfants-Malades or at the CCBB, a center for pediatric surgery.
The team has evolved over time. Currently the core of players craniofacial consists of:
Eric Arnaud (Plastic Surgeon – Team coordinator),Giovanna Paternoster et Syril James (Neuro-chirurgien), Philippe Meyer (anesthetist) et l’équipe d’anesthésistes-réanimateurs.
- Necker : Philippe Meyer, Thomas Baugnon, Stéphane Blanot, Brigitte Charron, Hari Cuttaree, Caroline Duracher, Anne-Catherine Perié, Antonio Vecchione, Estelle Vergnaud
- CCBB : Christophe Legros, Annick Guerard
- Necker : Jean Louis Dufier, Marie Andrée Espinasse Berrod
- Necker : Aurélia Diaz, Gaëlle Macquet-Nouvion
- Necker : Martine Le Merrer, Geneviève Baujat, Véronique Cormier-Daire
- Site Necker : Marie-Paule Morrisseau- Durand, Vincent Couloigner
- Necker : Francis Brunelle, Nathalie Boddaert, D Grevent
- Site Necker : Marie Line Lognoz, Stéphanie Broman
- Correspondant : Louis-Charles Roisin