Craniofacial anatomy and growth

The human head contains numerous bones surrounding the brain; together these bones are called the skull (or cranium). The bones of the face are suspended from the anterior portion of the cranium. This bony skeleton is responsible for the shape and form of the face and head. Abnormalities of this underlying bony skeleton lead to craniofacial problems and correction of these deformities is the object of craniofacial surgery.

The bones of the cranium are separated by sutures which allow early growth to occur. Normal sutures in a developing baby are quite wide with a large separation between the bones. This allows the rapidly growing brain to expand without restriction, displacing the cranial bones outwards. Most of the growth of the brain and the skull has occurred by the age of two, with periods of rapid growth during the first nine months of life. As the growth of the brain approaches completion the bony plates fuse together.

The facial bones develop in a similar fashion, although the time of rapid growth is in the teenage years. It is for this reason that many operations on the facial bones are delayed until later in puberty when most of the growth is complete, whereas cranial deformities are often corrected in infancy.