Major osteotomies of the cranium, facial bones, and mandible.

This paper describes the present status of osteotomies of the facial skeletal framework, including craniofacial surgery, in Japan based on patients seen at the Tokyo Metropolitan Police Hospital. It presents our experience with the correction of craniofacial dysostosis, orbital hypertelorism, orbital hypotelorism, untreated plagiocephaly, craniostenosis, cleft lip deformity, prognathism, and asymmetry of the mandible. There are a few departments skillfully performing such osteotomies in Japan, but it cannot yet be said that the procedures are well developed here. I myself have applied them in almost 100 patients in the past four years; considering the complexity and difficulty of these operations, however, my experience is quite limited and simply follows in the footsteps of previous work done mostly in western countries. Nevertheless, we can now treat most craniofacial and facial skeletal problems ourselves.