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Craniofacial Deformities
Few areas in plastic and reconstructive surgery have changed as rapidly as the management of complex craniofacial deformities. These deformities may be congenital in origin with subsequent growth disturbance of the facial skeleton; they may result after trauma; or they may be the sequelae of removal of tumors from the head and neck. As well, patients with discrepancy in the relationship of the upper and lower jaw resulting in either dental malocclusion or unusual facial proportions may benefit from reconstructive surgery.
Interestingly, one broken and malpositioned facial bone can distort the entire face. For instance, if a facial bone that contributes to the orbit is broken, a domino effect may occur. Facial features may flatten and the floor of the orbit may be lowered. This can cause a sunken abnormal eye position, with muscle dysfunction possibly resulting in double vision.
The improvement in treatment of these complex problems has come about because of several developments. The concept of wide exposure of the facial skeleton to adequately address the deformity through camouflaged incisions is now a basic principle. This makes correction or improvement of complex deformities possible, frequently in a single operation. The development of proper instrumentation utilizing tiny plates and screws allows for manipulation and movement of components of the facial skeleton in a safe and reliable manner.
Facial paralysis, caused by congenital deformity, tumor (for example, acoustic neuroma), or acquired problems such as Bell's palsy all result in dramatic distortion of normal facial features and the loss of one's ability to express emotion. This may lead to social isolation and destruction of self-image. Numerous operations are available to treat these difficult conditions, including crossfacial nerve grafting, local or free microvascular muscle transfer, or face lifting.
The craniofacial region (that area intimately responsible for vision, hearing, taste, smell, and the ability to breathe, chew and swallow) transverses the fields of may medical, surgical and rehabilitative disciplines. At University Plastic Surgeons Center for Reconstructive Surgery numerous specialists work closely together for comprehensive patient care.
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