title: New perspectives in the management of severe cranio-facial deformity.
abstract: It is postulated that craniosynostosis is due to a growth abnormality in all or part of the cranial capsule. Release of the stenosed part in the first months of life will re-establish the balance between the rapidly growing brain and eye, and the cranial capsule. Three periods for operative treatment are described: early, intermediate and late. Only in the early period can operative treatment restore normal growth dynamics; in the late period the aim is correction of an established deformity. The relationship between cranial clefts and frontonasal encephaloceles is explored. If the space-occupying encephalocele is removed early, the distorted facial bones adopt a more normal position, whereas cranial clefts do not respond to early operation by remoulding. The treatment of the acquired deformities of acute cranio-facial trauma have taken on new perspectives with the application of the multi-disciplinary approach and surgical techniques developed in the treatment of congenital deformities resulting in considerable reduction in the period of hospitalisation.
mesh_terms: D002648:Child; D002675:Child, Preschool; D003394:Craniofacial Dysostosis / Q000601:surgery; D003398:Craniosynostoses / Q000601:surgery*; D004677:Encephalocele / Q000000981:diagnostic imaging / Q000601:surgery*; D005004:Ethmoid Bone; D005260:Female; D005624:Frontal Bone; D006801:Humans; D007223:Infant; D008297:Male; D008588:Meningocele / Q000000981:diagnostic imaging / Q000601:surgery*; D009666:Nose / Q000002:abnormalities / Q000601:surgery; D012887:Skull Fractures / Q000601:surgery; D014057:Tomography, X-Ray Computed