Advances in congenital craniofacial surgery.

Abstract

Surgery for the correction of craniofacial anomalies has come a long way since its beginnings more than three decades ago. Throughout this period numerous developments have occurred in diagnosis and management, as well as a better understanding of the etiology of craniofacial anomalies. Significant technological advancements in imaging have allowed for more precise diagnosis and surgical planning. Quantitative analysis techniques have been developed allowing for more precise results analysis. Nonsurgical management techniques have improved, as has the understanding of the proper utilization of nonsurgical treatment. Most nonsynostotic cases of head shape abnormality can be successfully managed nonsurgically. Improvements in surgical management include ways of diminishing the need for transfusions. Operative technical refinements also allow for improved results. The discovery of intracranial migration of rigid fixation hardware has led to decreased utilization of the metallic implants. Bone cements and absorbable plating systems promise further enhancements. Distraction osseogenesis allows skeletal changes to be made gradually reducing risks. Finally, the etiologies of craniosynostosis are being elucidated and promise to lead to more elegant management, reducing or alleviating the need for surgery. Genetic manipulation may eliminate many of these problems.