Radical treatment of craniofacial anomalies in infancy and the use of miniplates in craniofacial surgery.

The radical treatment of craniofacial anomalies in infancy is indicated for medical, technical, and psychosocial reasons. The major problems around the cranium, the orbits, and the face may be safely corrected by osteotomy, suture resection and disjunction, mobilization, repositioning, and reshaping of the various skeletal segments. This radical approach has been possible through the introduction of miniplate fixation. The plates and screws are removed after 3 to 6 months to take optimal advantage of the great formative power of the growing brain, which expands rapidly within the first 2 years of life. In infants, disjunction is more important than advancement, making this approach a dynamic one in contrast with the static procedures for the adolescents and adults. The complete, one-stage procedures are superior to a delayed or two-stage procedure. Experienced administration of pediatric anaesthesia and intensive care are mandatory.