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Craniofacial surgery is the process of repairing or reshaping a person’s skull and face.
The word ‘craniofacial’ itself is a combination of the words cranium which refers to the upper part of the skull and facial which is the face in general. There are many reasons craniofacial reconstruction is performed which varies with each patient.
In children, this surgery is most commonly performed to repair abnormalities which could be as a result of child birth defects or a genetic disorder. This procedure may also be done to repair injuries, which may be as a result of accidents or an illness. When it comes to adults, the procedure is performed mostly to repair head and facial trauma injuries. It is also common in cancer patients to reconstruct their bone structure or tissue that could have been damaged after cancer tumor surgery.
Craniofacial surgery is performed to improve a patient’s appearance as well as restoring the functions of the jaw and mouth, as well as the sensory organs found around the face. It is a very complicated procedure due to the fact that it is performed around very sensitive areas which include the brain, the top of the spinal cord, the eyes and the opening of the breathing airways.
When it comes to craniofacial surgery in children, this procedure is performed to reconstruct defects caused as a result of birth abnormalities as well as genetic abnormalities. The consultation is done between the parents and the surgeon to first establish the cause and origin of the abnormalities. There are as many as 150 different genetic disorders that can be found in children. Once the cause is established a treatment plan is set up which will include psychosocial and surgical follow-ups. This procedure is quite complicated because the surgeon has to make way for the growth changes expected on the child’s skull and face while at the same time try and make the child’s features look as normal as possible. This procedure is done under general anesthesia and times can vary, but will usually take between 3 to 6 hours.
Craniofacial surgery performed as a result of trauma is performed after the patient is out of danger related to other organs. Most trauma patients requiring facial reconstruction will most likely have other injuries in other sensitive parts like the upper part of the body. This will have to be dealt with first before proceeding with the craniofacial surgery. Once this is done, x-rays of the facial injuries are taken to establish the extent of the injury and these scans can also be used to create metal or plastic implants that will be used to reconstruct the face. This procedure can take as long as 14 hours because the surgeon may strive to reconstruct the face in one operation to avoid the patient undergoing a second surgery procedure. The surgeon may choose to use bone grafts which are bone parts from other parts of the body or use polymer implants to repair facial bones. If there are broken bones, these may be replaced with titanium plates and surgical screws as opposed to using wires to put the jaw back into place. When it comes to the skin, the surgeon may choose to cut flaps of skin from other parts of the body and transplant these onto the face.
Risks and Complications
Approximately one-third of patients who receive an anaesthetic during surgery will experience “anaesthesia sickness” or post-operative nausea and vomiting (POVN).
There are certain risks that come with this type of surgery and they include:
Bleeding: This is a rare complication, but if it does occur, the surgeon can almost always stop any further bleeding. Additional surgery may have to be performed if the bleeding is as a result of improper bone replacement or fixing. There may be added risk of infection as a result of the bleeding.
Breathing Complications: This rare occurrence can be as a result of the anesthesia and reactions to the type of anesthesia used. It can also be caused by the type of medication used in the procedure.
Other risks related to craniofacial surgery include nerve dysfunction which can lead to total or partial loss of feeling in certain areas of the face. There is also risk of brain damage due to the proximity of the procedure to the brain. One can also experience partial or total loss of bone grafts as a result of this operation. Permanent scarring from the operation may also occur though this can be resolved with further facial surgery. All of these risks are extremely rare.
Q. Will I require further surgery once I have recovered from my craniofacial surgery?
A. The success of the surgery and in some cases the satisfaction of the patient is what determines if there will be a requirement for further surgery. The surgeon will strive to complete all the procedures within the one surgery to avoid any need for more procedures.
Q. How normal can I expect to look after the process?
A. This will be determined by the extent of the damage to the facial structure. The doctors will try their best to restore your looks to your original state or to the required level.
Q. Is there risk of permanent damage to my hearing or eyesight?
A. Permanent damage to your hearing or eyesight is extremely rare and could only occur if there is an error during the operation. Considering that this is a very sensitive operation, you need to ensure that you have selected the best craniofacial surgery doctor you can find. It is important to get referrals from other patients as well as consult a number of surgeons before proceeding with the procedure.