Management of nonsyndromic craniosynostosis

In approximately 1 in 1000 live births in the United States, an infant has some variant of a facial, skeletal, or craniofacial deformity. If cleft lip and palate deformities are included, the incidence is greater. Timing of the surgical management of these patients has been advocated from the first few weeks after birth until well into the second decade. Many of these patients require multiple, staged procedures that involve movements of the bone and soft tissue from the intracranial and extracranial approaches. The surgical approach to most of these congenital deformities was radically changed by techniques introduced to the United States by Paul Tessier of France in 1967. From his imaginative intracranial and extracranial approaches, numerous advances have been made that facilitate the care of most of these children. More recently, additional advances in pediatric anesthesia and biodegradable plating systems have improved the management of these complex craniomaxillofacial deformities.