The Dentist Magazine.

Cranial and facial deformities in children

Published: 18/05/2017

Abnormal skull shape, increased cerebral pressure with consequences such as headaches, visual disturbances or developmental disabilities – these are signs of craniosynostosis in children.

If these anomalies of the skull are surgically treated in the first year of life, a child can have a good chance of leading a normal life with a normal appearance. Even with other craniofacial deformities, the prognosis improves considerably when treated early. This is one highlight from experts at the 68th Annual Meeting of the German Society of Neurosurgery (DGNC). The congress took place from May 14-17 in Magdeburg.

Craniosynostosis is a premature ossification of one or more cranial sutures, resulting in an abnormal skull shape. Craniosynostoses may be inherited or can arise with no known cause. The disease occurs in about one of every 1,000-2,000 newborns. “The earlier a child is referred for medical assessment and surgery, the better the chances for an excellent result”, says Frederick Boop, head of pediatric neurosurgery at the Semmes-Murphey Clinic in Memphis (USA). “When surgeries are undertaken during the first months of life, excellent results can be achieved using minimally invasive procedures – with less blood loss, reduced hospital costs and lower risk.”

Other craniofacial deformities in children are not so widespread but often are more serious. These frequently include genetic disorders that involve various skeletal anomalies and developmental disabilities. “These abnormalities are more likely to result in serious disorders of skull and facial development”, explains Frederick. Disturbances of brain development, visual function and respiration, as well as skeletal anomalies associated with the malformation, are related problems. Here too, early treatment can significantly improve the prognosis. “New surgical methods such as minimally invasive surgery and distraction osteogenesis – extension of the jawbone – allow safer and better operation results”, says the neurosurgeon.

Treatment of craniofacial deformities in children is complex; an entire team of medical and health experts is required – this includes neurosurgeons, plastic surgeons, orthodontists, oral surgeons, geneticists, developmental-pediatric specialists, social workers and child psychologists. Most children require follow-up care that extends over several years. Individuals with severe craniofacial deformities may even require lifelong care. Affected children can receive optimum care in specialised health centers where an interdisciplinary team can address their needs in the short-term as well as in the long-term. Experts benefit from new developments when it comes to treatment. “The advancement of imaging techniques has meant our knowledge of skeletal development also increased; with the further development of surgical technologies, our surgical tools have become safer and more effective”, concludes Frederick.