Age-Related Differences in Psychosocial Function of Children with Craniofacial Anomalies

Volpicelli, Elizabeth J.; Pfaff, Miles J.; Hakimi, Kevin; Bradley, James P.; Solem, R. Christian; Lee, Justine C.

doi:10.1097/prs.0000000000003687

Cited by 41 publications

(37 citation statements)

References 47 publications

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“…Children with orofacial cleft suffer the highest incidence of depression, anxiety, and negative peer-relationships around the ages 8 to 10 years. 33 This supports a tiered-approach with psychosocial support, counselling, and surgery used together within a multidisciplinary cleft and craniofacial team.…”

Section: Intermediate Cleft Rhinoplastymentioning

confidence: 61%

Controversies in Cleft Rhinoplasty

2020

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Rhinoplasty for cleft lip nasal deformities challenges all cleft surgeons. There is great variability of phenotypical anatomy, but iatrogenic changes and scarring from the previous surgeries add another layer of complexity. Rhinoplasties on a patient with cleft lip–palate are technically and intellectually challenging to master requiring a patient-tailored approach. The shape and structure of the nose are changed to improve both function and aesthetic appearance. In the primary setting, nasoalveolar molding is a form of presurgical infant orthopaedics used for preparation before the cleft lip and nose repair. Intermediate stages should be conservative to minimize scarring, while the definitive cleft rhinoplasty utilizes cartilage grafts from septum, ear, or rib to sculpt the nose. Hereinto, we will outline the controversies, the evidence supporting certain techniques, and our preferences.

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Section: Intermediate Cleft Rhinoplastymentioning

confidence: 61%

Controversies in Cleft Rhinoplasty

2020

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“…Grade III: Absent auricle, the lobular remnant is anteriorly and inferiorly displaced [14]. (8) Dysmorphic type of skull shows a spherical big head with a medium-width nostrils, rounded orbital edges, prominent cheekbones, shallow canine fossae, moderate prognathism, absent brow ridges, giant skull sutures, prominent zygomatic bones, wide and flat nasal bridge, less prominent nasal spine, shovelshaped upper incisor teeth (scooped out behind), moderately wide palate shape, arched sagittal contour, wide, and flat face [15,16] The congenital defects affect 2-3% of all children and about 1% of them have syndromes or multiple deformities [1]. Syndromes consist of multiple malformations that could be etiologically or pathogenetically related or both.…”

Section: Introductionmentioning

confidence: 99%

“…CFA might be associated with diverse genetic and environmental factors. There is a significant psychological impact of altered facial and dental appearance in patients with craniofacial anomalies compared to controls [ 8 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Craniofacial Anomaly Association with the Internal Malformations in the Pediatric Age Group in Al-Fallujah City-Iraq

Farhan

A.Al-Abdely

Abdullateef

et al. 2020

BioMed Research International

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Context. Craniofacial anomalies (CFA) are a major cause of infant mortality and childhood morbidity. They may be simple or multiple and vary in their clinical importance. Objectives. To estimate the prevalence of craniofacial anomalies among Iraqi people and its association with other congenital malformations. Methods. A hospital-based cohort study. It was conducted in Iraq, Fallujah city from Jan 2019-April 2019. The pediatric age group below 16 years attending the consultation clinic. Results. The prevalence rate of craniofacial anomalies was 2%. There were 43 (54%) males and 37 (46%) females. A 55 cases (69%) out of total 80 cases have an association with other internal congenital malformations, and 25 cases (31%) have no association. Those associated internal malformations were categorized according to their types into congenital heart disease 33(60%), Renal diseases 9 (16%), CNS anomalies 8(15%), and GIT anomalies 5(9%). Conclusions. Craniofacial anomalies showed a relatively higher prevalence rate in comparison to other studies worldwide. It was found that the majority of craniofacial anomalies might be associated with other congenital systemic malformations. Furthermore, the necessary actions to identify the frequency and risk factors associated with craniofacial anomalies in the Iraqi population are emphasized to put a better strategy to establish future preventive programs and treatment.

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“…In terms of psychosocial ramifications, we and others have reported that significant psychosocial disturbances occur specifically in children with craniofacial anomalies between 8 and 10 years of age including increased anxiety, depression, poor peer relationships, obsessive-compulsive behavior, and aggression. 10 , 11 For these reasons, many surgeons will aim to perform reconstruction between ages 6 and 8 years.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of 4 Outcomes Measures in Microtia Treatment: Exposures, Infections, Aesthetics, and Psychosocial Ramifications

Mandelbaum

Volpicelli

Martins

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:In craniofacial microsomia, microtia and canal atresia pose formidable reconstructive challenges. We review our institutional experience in treating microtia and atresia to identify variables associated with 4 outcomes measures: complications, surgical revisions, aesthetic outcomes, and psychosocial function.Methods:Craniofacial microsomia patients treated at the University of California Los Angeles Craniofacial Clinic between 2008 and 2014 greater than 13 years of age (n = 68) were reviewed for microtia and atresia treatment and outcomes.Results:In total, 91.2% of patients diagnosed with craniofacial microsomia presented with microtia, affecting 75 ears. Both a male and right-sided predominance were observed. Fifty-six patients (90.3%) underwent autologous external ear reconstruction at an average age of 8.5 years. Age, type of incision, and size of cartilage framework did not predict total number of surgeries or complications. Severity of ear anomalies correlated with increased number of surgeries (P < 0.001) and decreased aesthetic outcomes (P < 0.001) but not complications. In total, 87.1% of patients with microtia had documented hearing loss, of which the majority were conductive and 18.5% were mixed sensorineural and conductive. Hearing deficits were addressed in 70.4% of patients with external hearing aids, bone anchored hearing aids, or canaloplasty. Of all variables, improvement of psychosocial function was correlated only to hearing loss treatment of any type (P = 0.01).Conclusions:On evaluation of surgical and patient characteristics, severity of microtia predicted the total number of surgical revisions performed and aesthetic ratings. In addition, we found that the only factor that correlated with improved patient and parent-reported psychosocial outcomes was treatment of hearing loss.

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Age-Related Differences in Psychosocial Function of Children with Craniofacial Anomalies

Abstract: Risk, II.

Cited by 41 publications

References 47 publications

Controversies in Cleft Rhinoplasty

Controversies in Cleft Rhinoplasty

Craniofacial Anomaly Association with the Internal Malformations in the Pediatric Age Group in Al-Fallujah City-Iraq

Evaluation of 4 Outcomes Measures in Microtia Treatment: Exposures, Infections, Aesthetics, and Psychosocial Ramifications

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