Major osteotomies of the cranium, facial bones, and mandible

Osteotomy design and execution

Craniofacial osteotomies are an integral part of contemporary neurosurgery because of their ability to provide substantially more exposure to deepseated lesions with reduced brain retraction. A systematic approach to the performance of these osteotomies coupled with meticulous bone work capitalizes on their advantages without producing any significant cosmetic defects. As their indications are progressively more clearly defined and familiarity and facility are gained by the surgeons performing them, operative time and morbidity should decrease. Lowering operative time and morbidity with excellent esthetic results is likely to be increasingly important when considering operative versus nonoperative management, particularly as nonsurgical modalities continue to develop.