Surgical Correction of Craniofacial Microsomia: Evaluation of Interventions in 565 Patients at Three Major Craniofacial Units

Craniofacial microsomia is characterized by an asymmetric hypoplasia of derivatives of the first and second pharyngeal arch, leading to a variety of phenotypic presentations. Studies on surgical correction of patients with craniofacial microsomia have small cohorts, leaving controversial opinions on...

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Bibliographic Details
Published in:Plastic and reconstructive surgery (1963) Vol. 143; no. 5; p. 1467
Main Authors: Pluijmers, Britt I, Caron, Cornelia J J M, van de Lande, Lara S, Schaal, Sontje, Mathijssen, Irene M, Wolvius, Eppo B, Bulstrode, Neil, Evans, Robert D, Padwa, Bonnie L, Koudstaal, Maarten J, Dunaway, David J
Format: Journal Article
Language:English
Published: United States 01.05.2019
Subjects:
Adolescent
Age Factors
Boston
Child
Facial Asymmetry - diagnostic imaging
Facial Asymmetry - etiology
Facial Asymmetry - surgery
Female
Goldenhar Syndrome - complications
Goldenhar Syndrome - diagnostic imaging
Goldenhar Syndrome - surgery
Humans
International Cooperation
London
Male
Mandible - abnormalities
Mandible - diagnostic imaging
Mandible - surgery
Netherlands
Orthopedic Procedures - methods
Prospective Studies
Reconstructive Surgical Procedures - methods
Reoperation - statistics & numerical data
Retrospective Studies
Time-to-Treatment
Treatment Outcome
London
Netherlands
Boston
ISSN:1529-4242, 1529-4242
Online Access:Get more information
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Summary:Craniofacial microsomia is characterized by an asymmetric hypoplasia of derivatives of the first and second pharyngeal arch, leading to a variety of phenotypic presentations. Studies on surgical correction of patients with craniofacial microsomia have small cohorts, leaving controversial opinions on the optimal treatment modality, the indication for surgery, and the optimal timing of surgery. The purpose of this study was to evaluate the types of, timing of, and total number of surgical corrections performed and the number of surgical procedures in correlation to the severity of the phenotype. A retrospective chart study was conducted including patients diagnosed with craniofacial microsomia from three large craniofacial units. Demographic, radiographic, and clinical information was obtained, including type and number of surgical procedures and age at the time of surgery. A total of 565 patients were included. In total, 443 (78.4 percent) of all patients underwent some form of surgery during their life, varying from skin tag removal to major craniofacial operations. The number of surgical interventions was higher with increasing severity of phenotype, bilateral presentation, and a younger age at the first intervention. Multiple surgical corrections are frequently seen in patients with a more severe or bilateral presentation. Furthermore, those who are treated earlier in life for correction of asymmetry of the mandible will undergo significantly more surgical procedures to correct the asymmetry later on, independent of the Pruzansky-Kaban type mandible. A prospective international multicenter study is designed with a uniform registration and outcome measurement tool to identify the optimal treatment strategy.
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ISSN:1529-4242
1529-4242
DOI:10.1097/PRS.0000000000005554