Pediatric craniofacial trauma: challenging pediatric cases-craniofacial trauma.

The pediatric population, as well as the adult population, is subject to similar injuries and traumatic events involving the craniofacial skeleton. Although less frequent than adult injuries, the craniofacial injuries sustained by children are considered separately in textbooks and the literature because of the special unique problems associated with their treatment and the effects they might have on growth and development that can arise as a result of their management. Some of the more challenging cases that I have seen involve the very young with cranial bone fractures and cranial base fractures and those that involve the nasal and/or orbital-ethmoidal areas in young children and their secondary reconstruction. Some of these types of cases are not always clearly and thoroughly addressed in textbooks or articles because of their infrequent occurrence. Often, surgeons differ in approaches to treatment because of certain anatomic or physiological factors specifically related to childhood, facial growth, and the timing of treatment. Some of the cranial and facial developmental malformations seen in older children or adults can be attributed to trauma sustained in early childhood. This is because trauma may have a deleterious effect on the growth and development of facial structures in the postnatal life similar to that seen resulting from a genetic mutation.