INFORMATION

The maxillofacial surgery unit is dedicated to the comprehensive treatment of head and neck pathology. It is a team with high capacity to treat from surgery children maxillofacial, head oncology, neck and skull base, craniofacial traumas and orbital, orthognathic surgery and facial plastic surgery.
Vast experience in reconstructive surgery and facial aesthetic surgery combination. We treat in a multidisciplinary way working jointly with other near specialities as ophthalmology and neurosurgery.

WHAT DO WE TREAT?

We take care of all kinds of maxillofacial surgery providing the best technology for diagnosing and planning all face surgery, particularly orthognathic surgery and facial plastic surgery software. Likewise, we have the best material to perform this type of pathology.

• Cleft lip and craniofacial dysmorphisms.
• Orthognathic surgery
• Temporomandibular joint pathology
• Head and neck oncology
• Skull base oncology
• Orbitopalpebral surgery
• Facial aesthetic surgery
• Reconstructive plastic surgery
• Preprosthetic surgery, dental preimplants
• Facial traumas and aftermaths

MEDICAL TEAM

Dr. Colmenero Ruiz, César Maximiliano Team leader
Más información

DrColmenero
  • Licenciado en Medicina y cirugía en 1987, nº 1 de promoción, premio extraordinario y premio fin de carrera. Universidad Autónoma de Madrid.
  • Nº 1 de MIR convocatoria de 1987.Especialidad cirugía maxilofacial. 1987-1992: residencia de cirugía maxilofacial en Hospital La Paz, Madrid.
  • 1992-2000: adjunto FEA de cirugía maxilofacial con especial dedicación a la cirugía oncológica y reconstructiva de base de cráneo, órbita, glándulas salivares y cavidad oral
  • 1998 Fellow European Board Oral and Maxilofacial Surgery. Zurich.
  • 1998 Doctor en Medicina. Sobresaliente Cum Laudem por unanimidad, Titulo: “Carcinoma de glándulas salivales”. UAM
  • 2000 Nº 1 de MIR especialidad O.R.L.
  • 2000-2004 residencia ORL en Hospital Ramón y Cajal de Madrid, con especial interés en cirugía oncológica y reconstructiva de faringe-laringe y base de cráneo.
  • 2004-2011 Práctica privada en múltiples Hospitales de Madrid
  • Estancias programadas en Jackson Memorial Miami 1992,1995,1998 Estancia programada CHOP (ChildrenŽs Hospital of Philadelpia) and HUS (Hospital Universitiy Pensilvania) 1995
  • Estancia en Memorial Sloan Kettering Center and Manhatahn Eye and Ear informary 1994-1996
  • Demandado conferenciante en foros de cirugía maxilofacial, ORL y base de cráneo, sobretodo en el tratamiento de los tumores de difícil abordaje y reconstrucción.
  • Múltiples publicaciones en revistas internacionales sobre biología, planificación y reconstrucción oncológica
  • Experto en Cirugía Reconstructiva de base de cráneo y maxilares.
  • Desarrollo especial de innovación y planificación en Cirugía Ortognática, últimas tecnologías tanto  a la hora de planificación con cirugía virtual, como planificación digital y uso de modelos tridimensionales
  • Estancia en Miami y Philadelphia donde desarrolló importante experiencia en el tratamiento de labio leporino, secuelas y cirugía craneofacial
  • Tratamiento de las complicaciones secundarias a los traumatismos faciales especialmente órbita y maxilar
SERVICES PORTFOLIO

Maxilofacial surgery takes care of the pathology affecting head and neck excluding Neurosurgery and Ophthalmology, which are specialities closed to them where the activity is continuous in a multidisciplinary way.
The performance field is:
Preposthetic surgery.Implants and previous grafting when there is a bone deficit
Oncological surgery.

• Skull base
• Orbita:
• Nose and paranasal sinuses
• Oral cavity, tongue, jaw
• Pharynx
• Neck
• Jaws
• Salivary glands
Reconstructive plastic surgery
• Local and regional flap of skin
• Vascular microsurgery
Facial traumas
• Orbita:
• Malar
• Skull

Nose orbitadysmorphismssurgerty
Orthognathic surgery, dentofacial abnormalities
Temporomandibular joint pathology
Cleft lip and dentofacialdysmorphisms.
Skull base surgery
Facial paediatric surgery
Implantation and pre-prosthethic surgery

The dental implants are the most natural way of missing teeth pieces replacement. We have been pioneers in this performance progresses and development.

We carry out implants with a 3D-digital planning minimizing the postoperative and performing a minimally invasive surgery.
In some cases, before a bone absence, we perform techniques of bone gain, whether biomaterial, intraoral graft and in extreme cases, hip extraoral grafts or vault for its posterior implants placing with a extremely high success rate.
Oncology and reconstructive surgery
The head and neck oncology means a 5-7% of the whole oncology.Surgery plays an important role.We work jointly with oncologist and radiotherapist physicians.
The stress is to wipe out the tumorand the immediate reconstruction to minimize the functional and aesthetic aftermaths.We use microsurgery reconstruction techniques specifically in the skull base tumor and oropharynx. Also in those with maxillae affection.

Each anatomical localization and the tumor origin location define the therapeutical and surgery action.
The knowledge of the tumor biology and the spread through the latest diagnostic techniques, allow us to destroy the tumor and, in such cases where the oncological committee determines it, the use of helpful therapies as chemotherapy and radio therapy.
Our hospital integrates the latest technology in medical and radiotherapy treatment to achieve a high rate of healing and to minimize the side effects.
We are especially involved in skull base and orbitatumors working jointly with neurosurgery.

Uro-oncology
Facial traumas and aftermaths
The facial trauma of high energy has significantly decreased.
I had the opportunity to perform several cases of high complexity during my training in La Paz University Hospital.
Part of my specialization was in US where I had the chance to train myself in the most complicated aftermaths, firearms injuries, falls and extremely serious car crashes.
We have a large experience and iconography of these tough cases in our speciality.
There is a special priority in orbitocranial pathology, with orbita volumetric alterations very difficult to handling. For them, we apply 3D digital planning.
Systematically, for these patients we combine aesthetic surgery techniques.

Orthognathic surgery
The orthognathic surgery act towards dentofacialalterarions of the lower two thirds of the face.
It implies a surgery with a significant effect on the aesthetic, dental occlusion, breathing and balance of the temporo-mandibular joint.

We keep developing this surgery since 1987, enforcing all the technological innovations both in OTs with high speed engines and the highest accuracy and ultrasound, to minimize the trauma and the cuts precision, as well as preparation, using CT (Cone Bean) and 3D software planning increasing previous information to the surgical performance and achieving the best cosmetic and functional result. We carry out a study of the effect on soft tissues and on the airway improving the respiratory pattern with it.

This is the surgery with the best results in the treatment of sleep apnea syndrome.

Pediatric surgery of craniofacial dysmorphisms, cleft lip and aftermaths
From 1990 to 1992, I stayed in Miami Children Hospital and Pennsylvania Children Hospital for learning children’s maxillofacial surgery.I had the luck to educate, know and even build up a friendship with Ralph Millard, Peter Randall and remarkably with Tony Wolfe. Many children around the world came with the most heterogeneous facial dysmorphisms in those long days of surgery and consultations.

Nowadays, it is maybe the subspecialty with most dedication. We work in a multidisciplinary way jointly with neurosurgeons, ophthalmologists, genetics, orthodontists and phoniatries for the comprehensive treatment of complex pathologies to minimize the cosmetic impact and to obtain the minimum functional aftermaths.
Even, in the best situations, it will be necessary several surgical procedures. The techniques combinations of soft and hard parts are crucial, and the support of aesthetic surgery techniques produce the best results. Long term follow up is basic.

Temporomandibular joint pathology
This pathology widespread is increasing. There are dental, maxillar, occlusal factors and secondary pathology of bruxism and stress interacting in it.
Most of the patients are treated in a conventional way with physiotherapy, splint and drugs.
A small percentage with pain and important functional limitation is treated successfully with surgery techniques, arthroscopy in slight cases and arthrotomy in moderate-severe cases.
Both techniques minimally invasive.
There is an inherent pathology of ATM as development alterations, tumors, hyper-growth and ankyloses with the skull base which are a challenge for the surgeon.

Skull base surgery
We are innovators in the development of this complex surgery jointly with neurosurgery.
Malformation pathology, dysplasia in the base and upper cervical column, trauma aftermath and tumors, expressly in the craniofacial intersection both benign and malign of difficult access and resolution. Surgeries are complicated, and they involve: a tumor basic anatomical knowledge, biology and tumor pathology knowledge, the aftermath managing knowledge, future complications and how to avoid them.My dual training of a specialist in maxilofacial surgery and otorlaryngology affords me a privileged situation.

Facial aesthetic surgery
For us, maxillofacial surgeons, our area of work is the face. We develop a complex aesthetic surgery by merging soft and hard tissue techniques and highlighting the function.

The aim is to improve the aesthetics and function without impairment of one versus the other.
We are pioneers in the latest innovations in structural rhinoplasty techniques developed by maxillofacials and otolaryngologists.

Latest innovations in rejuvenation surgery come from the development of maxillofacial approach modern techniques.
Blepharoplasty and lift are real instances in which, in a natural way, cosmetic results are obtained authentically.There is a quick recovery applying minimally invasive techniques.