Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4533_Библиотеки_им_академика_М_И_Перельмана

philosophy”:

Beauty is no quality in things themselves: It exists merely in the mind which contemplates them; and each mind perceives a different beauty.

The head is the most complex structure of the body. The skull, including the bones that enclose and protect the brain and sensory organs, also acts as a scaffold for the face to support the functions of feeding, breathing, and non-verbal communica­tion in combination with connective tissue, mus­culature, vasculature, and associated innervation.

Parents will have expectations and hopes for their child even before it is born, with many pro­spective parents feeling slightly nervous about whether the child will be healthy. At the time of the birth, the two most common questions are about the sex (boy or girl) and the physical health and the absence of malformations. The reaction to having produced a child who is in some way disgured begins at this point [17–

Patient-physician communication is difcult in multiple aspects. The early interaction is taken, when the child is newborn and there is no chance of verbal communication. Parents serve during this period and for a long time as a decider and communicator with physicians. Later on, as ver­bal communicative skills improve in children, it is difcult for both parties to nd a level of emphatic and understandable interactions. Additionally, the surgeon as one mainstay in therapy has often a more technical approach to patients. As patients grow up and reach the stage of puberty, communication and patient-physician interactions become even more complicated. This complex situation seems to be the basis that patient often thinks that therapists cannot relate.

the history of cleft repair (mostly a soft tissue facial plastic surgery) and repair of craniosynos­toses (mostly a bone- based surgery including the skull; craniofacial surgery).

teenth century to replace teeth was the homolo­gous transplantation of teeth in humans [22]. Enlightenment into the biological and surgical mechanisms that accounted for the fate of surgi­cal strategies was given by the fundamental bio­logical work of Rudolf Virchow [23] (1821–1902, Fig.1.11).

Except Hippocrates’ rst historical description of craniosynostosis in 100 BC, Sömmerring and Otto [28, 29] initially described in 1800 and in 1830 that premature cranial sutural fusion would result in deformity, and the etiol­ogy was thought to be based on either fetal or birth trauma. In 1851, Virchow [23] rst intro­duced the term of “craniosynostosis” and for­mulated what is today known as Virchow’s law: there is a cessation of growth that occurs in the direction perpendicular to that of the affected suture, while growth proceeds in a parallel direction. On the other hand, similar groups of the craniosynostosis had been reported and classied in terms of each characteristic prob­lem over the years. In 1906, although brachyce­phalic craniosynostosis with syndactyly had already been reported toward the end of the nineteenth century, the French pediatrician Apert [30] is generally credited with describing the condition. In 1912, Crouzon [31], a neurol­ogist, reported the condition that is named after him. Based on the concept, the abnormal cal­varial growth due to a premature fusion of the sutures provided the basis for early operative treatment of craniosynostosis, with removing the offending suture in an attempt to release the constricted brain. In 1890, Lannelongue in Paris described bilateral strip craniectomies for the treatment of craniosynostosis, and Lane fol­lowed the intervention 2years later in the USA [

rst established a multidisciplinary craniofacial teams in Paris [37]. In 1967, he showed a pro­cedure of fronto-orbital advancement with cra­nial vault remodeling, with reshaped removal bone pieces stabilizing back to the cranium.

Future improvements in craniofacial medicine can be based on advances in all medical special­ties. Not only surgical proceedings but also inno­vative aspects of disease diagnostics and conservative treatments will help patient out­come. In the near future, medical genetics may play a prominent role. Studies of responsible gene location or clone hopefully reveal each min­ute pathology and prognosis and can be a founda­tion and application of gene therapy.

tinely addresses patients’ physical and psycho­social needs as part of the patient care pathway. They are initiating campaigns for giving people with facial disgurement a platform, in order to provide better and more information, increase awareness among health- and social care profes­sionals, and improve both access to and quality of psycho- social therapies. They also inuence and support the work of clinicians and profes­sionals in the many specialties that care for peo­ple who have disguring conditions as well as those in primary care. An increasing number of health and social care professionals are now seeking to embed psychosocial interventions into their care as a crucial part of best practice as an essential component to successful reha­bilitation. It is assumed that adequate psychoso­cial care not only decreases the distress experienced by patients; it also lowers costs in the longer term and helps to reduce health inequalities.