Craniofacial Deformity Surgeries

**3**

**Chapter 1**

*Raja Kummoona*

**1. Introduction**

meningeal arteries [1, 2].

ing with war-injured soldiers [3].

and many of them attempted suicide.

in reconstructive surgery.

including the orbits, midface, and jaws.

drilling holes in the cranial vault (trephination).

Prologue: Foundation and

Progress of Craniofacial Surgery

of Deformity and Malformation

Surgery of craniofacial malformation and deformity is a surgical subspecialty that deals with acquired and congenital deformity of the skull and facial skeleton,

The history of craniofacial surgery is not new but began with ancient humans

In Europe, and especially in France, 40 out of 120 prehistoric skulls were found with drill holes in the skulls. This technique is currently practiced to reduce intracranial pressure and the evacuation of supradural hematoma from the middle

Craniofacial anomalies have been known throughout history and both Hippocrates and Homer have touched upon the subject. Surgery was possible with the invention of general anesthesia in the mid-nineteenth century and was helped later with the discovery of penicillin by Sir Alexander Fleming of St. Mary's

Surgeons like Sir Harold Gillies (UK), Hippolyte Morestin (France), and Jan F. Esser (Netherland) were pioneering the specialties of plastic surgery while deal-

In ancient times, reconstructive craniofacial procedures of the soft tissue were performed to reconstruct the nose or ears. Sushruta and other Indian doctors were

In India during Sushruta's time, it was common practice for criminals to have their noses amputated because the procedure was considered to be a symbol of reputation and respect. Groups of potters known as Koomas developed a technique

In Iraq during the Iraqi/Iranian War (1980–1988), young soldiers who avoided front line duty were punished by the Saddam regime by cutting part of their ears or making a symbol on their forehead. This prevented doctors from repairing the created defect and deformity; it was a very depressing procedure for young people

Gaspare Tagliacozzi of Bologna was a genius surgeon, and in 1597 was chosen to reconstruct a deformed nose. He did reconstruction of the nose by elevating the pedicle bicipital arm flap as tube pedicle and mobilizing the flap for reconstruction of the nose deformity. This technique required 14 days of immobilization of the arm

The author believes that this technique was the first to use the tube pedicle flap

to attach the face, followed by division and inset of the flap from the arm [5].

Hospital, Paddington, London, during the Second World War.

practicing reconstruction of noses and ear lobes in 600 BC [2].

of nasal reconstruction to help people with these problems [4].

## **Chapter 1**
