The present and future of craniofacial surgery in Korea

ABSTRACT

The five major areas of concern in craniofacial surgery are the cleft lip and palate, hemifacial microsomia, craniosynostosis and its accompanying craniofacial syndromes, maxillofacial surgery, and breakthrough research on the each of these. Furlow's double opposing Z-plasty and 2-flap palatoplasty are often used to correct the cleft palate. Hereafter, the most appropriate surgical timing and methods must be determined through a prospective randomized control study. Currently, Millard's rotation advancement flap technique is generally used to correct the cleft lip. The repair of a cleft lip and especially a bilateral cleft lip is supplemented by presurgical orthodontics. Effort toward mastering the simultaneous repair of the nose continues. For hemifacial microsomia, distraction osteogenesis, orthognathic surgery, and fat injection is employed to correct facial asymmetry. Tissue engineering will soon be introduced as a treatment option. Currently, craniosynostosis is treated with methods such as total calvarial vault remodeling, endoscopic suturectomy, and distraction osteogenesis. In the future, a simpler and less invasive surgical technique must be developed. Maxillofacial (orthognathic) surgery generally refers to the bilateral sagittal split ramus osteotomy and LeFort I osteotomy. In the future, minimally invasive surgical techniques using endoscopes or robots will be introduced. Through the development of recombinant DNA technology, genetic research of craniofacial anomalies has identified many relevant genes. In the future, gene therapy will be plausible. Through advancements in tissue engineering, regeneration of tissue to correct congenital craniofacial deformities through autologous stem cells and scaffolds will be conceivable in the near future.