SOME ASPECTS OF CRANIOFACIAL SURGERY

V.A. Belchenko, A.G. Prityko, L.A. Kaurova, I.S. Alekseeva

Science and Practice Center of Medical Care Rendered to Children with Developmental Craniofacial Defects and Congenital Diseases of the Nervous System

Restoration of contours of a face and fornix of the scull in patients with congenital and acquired deformities is one of important problems which has not been solved fully so far. It is connected with variety of clinical manifestations demanding joint and consecutive activity of neuro- and craniofacial surgeons.

The authors analyze clinical, roentgenologic and functional indices of 665 patients with congenital and posttraumatic defects and deformities of visceral and cerebral cranium; 567 and 98 of them were patients aged 18-56 and children at the age of 7 months-17 years respectively.

Auto- and allotransplants of a membranous origin and metal constructions made of titanium were used for elimination of posttraumatic defects of a skull fornix and facial bones. Operations were characterized not only by elimination of defects but also by restoration of normal contours of a skull and face and sanitation of accessory nasal sinuses. Treatment of patients with Cruzon’s syndrome, trigono-, turri- and plagiocephalus was based on a method of “a swimming forehead” which allowed to restore normal contours of a frontal bone and dimensions of an anterior base of the skull. Patients with orbital telorism underwent circular orbitotomy with drawing orbits nearer to each other, transnasal canthopexia and reconstruction of a nose. Complex surgical treatment of all patients with use of up-to-date methods made it possible to eliminate congenital and acquired defects and deformities of both visceral and cerebral cranium, diplopia, enophthalmos, exophthalmos and to restore binocular vision, nasal breathing and normal proportions of a face and skull.