Particular Problems of Craniofacial Surgery

V.A. Belchenko, A.G. Prityka, E.V. Mamedov, Yu.A. Petrov

(Research and Practice Center of Medical Care of Children with Developmental Craniofacial Defects and Congenital Diseases of the Nervous System, Chair of Craniomaxillofacial Surgery and Stomatology, Russian State Medical University, Moscow)

Appearance of such a new specialty as craniofacial surgery in our country has given rise to numerous problems, connected with organization, training of specialists, full-value and qualitative estimation of existing pathology and rendering expert medical care. Craniofacial surgeons deal with treatment of patients with congenital or acquired craniofacial defects and deformities of bones and soft tissues. Earlier it was a sphere of activity of neurosurgeons, otorhinolaryngologists, ophthalmologists, surgeons-stomatologists and plastic surgeons, who tried to restore functions and to solve cosmetic problems, working separately. Today it is done with joint participation of a craniofacial surgeon and a neurosurgeon. A complex approach to treatment of patients with craniostenosis allows to eliminate hypertension and to reconstruct a deformed fornix, skull base, upper and middle areas of a face simultaneously. Patients with anterior craniocerebral hernias undergo herniotomy, closure of soft tissue and bone defects and, if necessary, elimination of orbital hypertelorism and nose reconstruction. Defects of cerebral and visceral skull, resulting from neoplasm removal, trauma or gunshot wounds are eliminated by means of autografts of membranous origin and titanium metal constructions with taking into account a curvature of a recipient zone and a defect area. The skull reconstruction in patients with craniofacial dysostosis is carried out with considering a lesion of its fornix and base, facial bones and soft tissues.