Craniomaxillofacial Buttresses PDF – Anatomy and Operative Repair

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Preface

In the 10th and 11th centuries CE, buttresses able to bear immense stress loads were introduced, facilitating cathedrals, synagogues, and mosques of greater drama, size, and height. Triggered by the desire for massive roofs of limestone, mortar, and brick, the early engineering process was vetted over the many centuries of the Renaissance.
Surgeons were slow to recognize the parallels to sanctuary architecture existing in the human craniofacial skeleton, such as imbedded buttresses, “flying” buttresses (outjuttings/arches), and microbuttresses (internal struts); platforms; trusses and trajectories; and joins (sutures), each permitting the offloading of stresses created by mastication and traumatic impact. The oversight was corrected at the turn of the 20th century as Le Fort, Testut, Keen, and notably Cryer analyzed the human craniofacial skeleton. Subsequent pioneers followed their early lead and championed reconstitution of the craniofacial skeleton after trauma, even in the presence of widespread comminution.
I briefly first acknowledge the long-overlooked parallels in classical architecture and the craniomaxillofacial skeleton ( Chapter 1 ) and then review the structural physics and load bearing capacity of the craniofacial skeleton ( Chapter 2 ). The section on finite analysis was contributed to significantly by colleagues Rudderman, Mullen, and Phillips and provides insight into the complexity and capacity of the craniofacial skeleton. Principles of repair are discussed in Chapter 3 , as foundations for finesse in buttressing. Chapters 4 to 9 off er clinical insights, with significant contributions by Drs. Schubert, Phillips, and Gossman in Chapters 5, 7, and 8, respectively.
Each clinical chapter is divided into two parts. In Part 1 , key surgical anatomy provides an anatomical framework for assessment and operative planning. In Part 2 , clinical presentation, radiographic assessment, and operative repair precede brief comments regarding collateral damage. This repetitive format provides the reader with clinical continuity, from chapter to chapter, regardless of anatomic site. A generous number of algorithms, medical art, and photographs enrich the text, followed by exemplary cases.

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craniomaxillofacial buttresses anatomy and operative repair
craniomaxillofacial buttresses anatomy and operative repair pdf

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