Correction of hypertelorbitism: evaluation of relapse on long-term follow-up
| Autor: | James P. Bradley, Cassio Raposo do Amaral, Christina J. Tabit, Derrick C. Wan, Henry K. Kawamoto, Neil Tanna, B Levi |
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| Rok vydání: | 2012 |
| Předmět: |
Reoperation
medicine.medical_specialty Long term follow up Cephalometry medicine.medical_treatment Bone Screws Osteotomy Recurrence Bone plate Sphenoid Bone medicine Maxilla Humans In patient Longitudinal Studies Child Nasal Septum Retrospective Studies Intraoperative Care Hypertelorism business.industry Age Factors Retrospective cohort study General Medicine Surgical correction Craniometry Plastic Surgery Procedures Surgery Ethmoid Bone Treatment Outcome Otorhinolaryngology Child Preschool Frontal Bone Physician satisfaction business Tomography X-Ray Computed Bone Plates Orbit Follow-Up Studies |
| Zdroj: | The Journal of craniofacial surgery. 23(1) |
| ISSN: | 1536-3732 |
| Popis: | Background Hypertelorbitism has been associated with a variety of congenital deformities. Appropriate timing for surgical correction remains controversial. We present our long-term experience of 33 patients with hypertelorbitism undergoing facial bipartition or orbital box osteotomy. Methods Patients with hypertelorbitism treated with either facial bipartition or orbital box osteotomy and repositioning who had long-term follow-up were studied (n=33). Age at the time of first surgery, preoperative interdacryon distance, and immediate postoperative interdacryon distance were recorded. Relapse was determined on postoperative follow-up, and the need for secondary correction was noted. Physician satisfaction score (range, 0-4) was also assessed. Results Patients had a mean total follow-up of 14.0 years. With regard to age at the time of initial procedure, patients younger than 6 years were all noted to have relapse, and 83% underwent revision surgery. In patients 6 years or older, only 11% had relapse and required a second operation. Yet, satisfaction scores were similar (3.2 versus 3.5). With regard to the severity of hypertelorbitism, there was no relapse noted among patients with mild hypertelorbitism (interorbital distance [IOD], 30-34 mm). Among those with moderate hypertelorbitism (IOD, 35-40 mm), 29.4% developed relapse. By contrast, all patients with severe hypertelorbitism (IOD, >40 mm) were noted to have relapse requiring repeat correction. Satisfaction scores were similar (3.4 versus 3.3 versus 3.1). Conclusions Relapse after surgery for hypertelorbitism is related to the age of the patient at correction and the preoperative severity. When possible, surgical repositioning of the orbits should be delayed until later childhood. |
| Databáze: | OpenAIRE |
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