Craniofacial developmental concepts in dynamic osteotomies and the Nautilus technique: A procedure created in Brazil for the treatment of craniosynostosis

Abstract

Craniofacial development is the major focus of attention in surgical treatments for craniosynostosis. Growth rate, size, shape, and proportion of soft tissue and bone structures of the skull and face are determinant factors in the establishment of the vital functions of swallowing and breathing, as well as in the aesthetic balance of facial features, so important for the patient's psychological identity. This manuscript revisits the concept of craniosynostosis and reviews the major biological and anatomical factors that come into play in the developmental process of craniofacial structures, especially during infancy and early childhood. It also describes the Nautilus surgical technique, a corrective procedure created and implemented in Brazil in 2011—how it was created and how it has evolved: as we look back into the past 10 years, we shed light onto what was learned, on our contributions to improve treatments over time, and on how much we still have to discover in this fascinating area.