Management of median and paramedian craniofacial clefts
| Autor: | Eva Meia Rüegg, Bénédict Rilliet, Brigitte Pittet-Cuénod, Denys Montandon, Paolo Scolozzi, Andrea Bartoli |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Box osteotomy Adolescent Telecanthus Nose 030230 surgery Encephalocele Craniofacial Abnormalities 03 medical and health sciences 0302 clinical medicine stomatognathic system Facial bipartition medicine Humans Medial faciotomy Patient group Craniofacial Hypertelorism Child ddc:617 business.industry Infant Plastic Surgery Procedures medicine.disease eye diseases Surgery ddc:616.8 body regions stomatognathic diseases Frontal bone Canthopexy Child Preschool 030220 oncology & carcinogenesis Maxilla Nasal reconstruction Female sense organs medicine.symptom Complication business Craniofacial cleft |
| Zdroj: | Journal of Plastic, Reconstructive & Aesthetic Surgery, Vol. 72, No 4 (2019) pp. 676-684 |
| ISSN: | 1748-6815 |
| Popis: | Summary Background Median and paramedian craniofacial clefts are associated with hypertelorism, anterior encephalocele, positional abnormalities of the maxilla, and nasal deformity. Cleft lip and palate, eyelid coloboma, and widow's peak are frequently present. Methods The authors collected data from 30 patients (mean age, 5.8 years; range, 4 months to 18 years) operated between 1986 and 2017 with median or paramedian craniofacial clefts of differing degrees of severity. Malformations of the different anatomic units and their surgical treatment were assessed, as well as complication rates. Results All patients presented nasal malformations and either telecanthus (n = 16) or hypertelorism (n = 14). Most patients (n = 23) had anterior encephalocele. All patients underwent nasal corrections, and most of them had medial canthopexy (n = 24). Excision of encephalocele was associated with fronto-orbital remodeling. Medialization of the orbits was performed in 11 patients, mainly by box shift (n = 9). Patients from outside Switzerland (n = 23) were operated at an older age than those in the native patient group. Because of staged reconstruction, 13 patients had more than one operation. Surgical complications included three infections and one expander exposition. One patient had bone resorption of a frontal bone flap. Nasal correction needed more than one procedure in 5 patients, and medial canthopexy had to be repeated in 7 patients. Esthetic results were satisfactory, permitting social integration. Conclusion Median and paramedian craniofacial clefts need adapted and carefully planned corrections respecting the growth of anatomic units. The quality of the medial canthal and nasal reconstruction is to a large extent responsible for the overall result. |
| Databáze: | OpenAIRE |
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