Maxillofacial, craniofacial, and cleft surgery

Maxillofacial surgery in paediatrics ranges from straightforward oral surgery to complex reconstructive surgery of the maxilla and mandible in cases of congenital or acquired abnormality. Craniofacial surgery is undertaken in supra-regional units and involves a multidisciplinary team of maxillofacial, neuro, and plastic surgeons. Much of craniofacial surgery in paediatrics is for craniosynostosis (premature fusion of one or more sutures of the skull) and can involve significant blood loss. Cleft lip and palate surgery in the UK is undertaken in a small number of regional centres, mainly by plastic surgeons. Anaesthesia for these specialities requires clear understanding of the procedure to be undertaken and readiness for potential perioperative complications. All these areas of practice need a good knowledge of, and ability in, the management of the difficult airway.