Abstract
Craniofacial surgery with a transcranial exposure carries a high risk of complications. Over a 14-year period, 95 patients were operated on transcranially with the following conditions: congenital anomalies (Apert's syndrome, Crouzon's disease, simple craniosynostosis, orbital hypertelorism), tumors (fibrous dysplasia, neurofibromatosis, sareoma, carcinoma) and trauma (primary or secondary reconstructions). These procedures involved the plastic surgery and neurosurgery teams in combination for surgical exposure and correction of complex craniofacial problems. The complications ranged from anemia, infection, CSF leakage, seizure, to the most serious one, death. The overall complication rate was 33%, and the major complication rate was 24%. In statistical analysis, the dura tear was correlated with CSF leaks (p＜0.05). Blood loss was greater in procedures with complication (p＜0.05), and operating time was longer in operations with complication (p＜0.05). Intraoral incision did not increase the morbidity, and operating time was not correlated with infections. The causes of some major complications were investigated and the methods for reducing the complication rate were proposed.
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