Craniofacial surgery in children: concepts and questions.

Craniofacial surgery is an exciting new subspecialty of medicine. It is strictly a team project that will function well only in a tertiary medical center. Particular coordination is needed among the plastic surgeon, neurosurgeon, anesthesiologist, and pediatrician. This article considers many of the potential advantages and some of the disadvantages of performing craniofacial surgery on infants. It is difficult or impossible, based on current knowledge, to predict the ultimate limits of such new techniques. The history of surgical evolution, however, continues to demonstrate that what "at first observation" was thought to be impossible or undesirable often evolves, with more understanding, to be the desired course of action. It was entirely appropriate that the initial craniofacial surgical efforts be generally confined to adult-type patients, but the currently available technical refinements have developed such procedures to the point where they now have a definite place in infant surgery as well. Continued clinical investigative research will provide further information regarding the eventual benefits and perhaps will lead to surgical techniques in neonates that will actually prevent the development of certain predictable deformities.