Craniofacial Surgery

Craniofacial surgery is a technique, devised by Dr Paul Tessier in Paris, to correct severe facial deformity. It aims to hide scars either within the hair or mouth or in natural skin creases. It provides access not only to the soft tissues, but also to the bones of the face allowing jaws, cheekbones, eye sockets and the skull itself to be reshaped or rebuilt as necessary.

For many syndromic facial deformities, such as Crouzon syndrome, Apert syndrome, Pfeiffer syndrome and severe facial clefts, the craniofacial surgeon operates with a neurosurgeon to gain access to the upper part of the face and skull. Some procedures, particularly if there is concern about raised intracranial pressure (the pressure inside the skull, around the brain) are carried out in infancy and others, particularly those involving the jaws, may be delayed until growth is complete at 16 or 17 years.

This is a complex specialty and, although it is fundamentally surgical in nature, it requires a large team of specialists to care properly for the patients: craniofacial surgeon, neurosurgeon, orthodontist, specialised anaesthetist, specialised nurses, Ear Nose and Throat surgeon, ophthalmologist, audiologist, speech therapist and clinical psychologist.

In the UK, there are four 'supraregional centres' carrying out craniofacial surgery. These are situated at the Hospital for Sick Children NHS Trust Great Ormond Street, Oxford, Birmingham and Liverpool.

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