Upper and Lower Limb Anomalies in Craniofacial Microsomia and Its Relation to the OMENS+ Classification: A Multicenter Study of 688 Patients.

Autor:	Renkema RW; From the Dutch Craniofacial Center, Department of Oral and Maxillofacial Surgery., Houwen T; From the Dutch Craniofacial Center, Department of Oral and Maxillofacial Surgery., van Nieuwenhoven CA; Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Sophia's Children's Hospital., Padwa BL; Craniofacial Centre, Boston Children's Hospital., Forrest CR; Craniofacial Centre, the Hospital for Sick Kids., Dunaway DJ; Craniofacial Unit, Great Ormond Street Hospital., Koudstaal MJ; From the Dutch Craniofacial Center, Department of Oral and Maxillofacial Surgery.; Craniofacial Centre, Boston Children's Hospital.; Craniofacial Unit, Great Ormond Street Hospital., Caron CJJM; From the Dutch Craniofacial Center, Department of Oral and Maxillofacial Surgery.; Craniofacial Unit, Great Ormond Street Hospital.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery [Plast Reconstr Surg] 2023 May 01; Vol. 151 (5), pp. 1053-1061. Date of Electronic Publication: 2022 Dec 21.
DOI:	10.1097/PRS.0000000000010090
Abstrakt:	Background: Craniofacial microsomia (CFM) is characterized by several malformations related to the first and second pharyngeal arch. Patients typically present with facial asymmetry, but extracraniofacial organ systems might be involved, including limb anomalies. The purpose of this study was to analyze the occurrence of upper and lower limb anomalies in CFM patients. Furthermore, the relation between limb anomalies and the OMENS+ (orbital distortion; mandibular hypoplasia; ear anomaly; nerve involvement; soft-tissue deficiency; and associated extracraniofacial anomalies) classification was examined. Methods: A retrospective study was conducted including patients with CFM from craniofacial units in three different countries. Patients were included when clinical and/or radiographic images were available. Demographic, radiographic, and clinical information was obtained. Results: A cohort of 688 patients was available and selected for analysis. In total, 18.2% of the patients were diagnosed with at least one upper and/or lower limb anomaly. Upper and lower limb anomalies were seen in, respectively, 13.4% and 7.8% of patients. Patients with other extracraniofacial anomalies had a significantly higher risk for limb anomalies (OR, 27.98; P = 0.005). Laterality of CFM and a higher OMENS score were not associated with limb anomalies. Conclusions: More than one in six patients with craniofacial microsomia have limb anomalies. Therefore, clinical awareness for these anomalies is warranted. Examination and, if present, follow-up on limb abnormalities in patients with CFM should be implemented in the standard assessment of CFM patients. Clinical Question/level of Evidence: Risk, III. (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.)
Databáze:	MEDLINE
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