Abstract

Hemifacial Microsomia and Rare Facial Lefts: Clinical and Surgical Aspects

by Gosla Reddy

Developmental craniofacial anomalies can occur as a consequence of abnormal and non-physiological sutural fusion of cranial bones which normally are supposed to be fused after 1 year of birth. When one or more sutures are prematurely closed, the compensatory growth starts perpendicular to the patent sutures since the brain still grows and expands in the direction of lower resistance. If left untreated, craniosynostosis can affect the development of the child; this is due to the restriction for growth of the brain and damage to the brain tissue due to increased intracranial pressure. The degree of developmental delay hinges on the kind of craniosynostosis. Children with sagittal synostosis have a lower risk of learning disabilities. The major functional problems associated with craniosynostosis are intracranial hypertension, visual impairment, limitation of brain growth, and neuropsychiatric disorders. In general, the functional problem increases as the number of sutures involved increases. It can be classified into syndromic and non syndromic and it affects at various levels. With early identification of developmental gaps and placement in support programs, a negative academic and cognitive outcome for these children could be reduced if not prevented. The uncomplicated and non-syndromic types can be managed surgically but electively compared to some syndromic forms that require urgent surgical intervention due to the involvement of the airway, ophthalmologic, and neurological system. Extent, as well as the type of surgery, depends on the age and presentation of the patient.

Learning Objectives

After this lecture, you will be able to define craniofacial anomalies, identify the problem areas, realise the need of correction
After this lecture, you will be able to classify the craniofacial framework into various levels, recognize the importance of anatomy, demonstrate the need of intervention
After this lecture, you will be able to intervene, to evaluate and propose the knowhow of timely decision making , as when to operate and when not to, how to act