Combined Report of Problems and Complications in 793 Craniofacial Operations

Whitáker, Linton A.; Munro, Ian R.; Salyer, Kenneth E.; Jackson, Ian T.; Ortiz‐Monasterio, Fernando; Marchac, Daniel

doi:10.1097/00006534-197908000-00011

Cited by 251 publications

(85 citation statements)

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“…The most frequent complication in our series was postoperative hyperthermia of unknown cause (13.43%) followed by cranial infection (7.5%). As in other publications, our infection rate was lower than 10% 13,15,41,44 . Subgaleal haematomas (5.3%), dural tears (5%) and CSF leakage (2.5%) occurred but in a significantly lower proportion than is reported by others 13 .…”

Section: Complicationssupporting

confidence: 84%

“…Fortunately, we experienced only 2 deaths in our series that occurred 1-year after the initial treatment, although the basal encephalocele of the patient with Pfeiffer's syndrome was deemed as a severe complication of our treatment. Except for this case, most complications solve favourably according to different authors 11,13,15,41,44,45 and to our own experience. The most frequent complication in our series was postoperative hyperthermia of unknown cause (13.43%) followed by cranial infection (7.5%).…”

Section: Complicationssupporting

confidence: 58%

“…The scarcity of available publications dealing with complications is also surprising. In addition, most of them are included in clinical series regarding general aspects of the craniosynostoses 16,41,[44][45][46] or dealing with postoperative infection 13,25,48 .…”

Section: Introductionmentioning

confidence: 99%

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Surgical treatment of isolated and syndromic craniosynostosis. Results and complications in 283 consecutive cases

et al. 2008

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SummaryObjective. To review the results and complications of the surgical treatment of craniosynostosis in 283 consecutive patients treated between 1999 and 2007.Patients and methods. Our series consisted of 330 procedures performed in 283 patients diagnosed with scaphocephaly (n=155), trigonocephaly (n=50), anterior plagiocephaly (n=28), occipital plagiocephaly (n=1), non-syndromic multi-suture synostosis (n=20), and with diverse craniofacial syndromes (n=32; 11 Crouzon, 11 Apert, 7 Pfeiffer, 2 Saethre-Chotzen, and 2 clover-leaf skull). We used the classification of Whitaker et al. to evaluate the surgical results. Complications of each technique and time of patients' hospitalization were also recorded. The surgeries were classified in 12 different types according to the techniques used. Type I comprised endoscopic assisted osteotomies for sagittal synostosis (42 cases). Type II included sagittal suturectomy and expanding osteotomies (46 cases). Type III encompassed procedures similar to type II but that included frontal dismantling or frontal osteotomies in scaphocephaly (59 cases). Type IV referred to complete cranial vault remodelling (holocranial dismantling) in scaphocephaly (13 cases). Type V belonged to fronto-orbital remodelling without fronto-orbital bandeau in trigonocephaly (50 cases). Type VI included fronto-orbital remodelling without fronto-orbital bandeau in plagiocephaly (14 cases). In Type VII cases of plagiocephaly with frontoorbital remodelling and fronto-orbital bandeau were comprised (14 cases). Type VIII consisted of occipital advancement in posterior plagiocephaly (1 case). Type IX included standard bilateral fronto-orbital advancement with expanding osteotomies (30 cases). Type X was used in multi-suture craniosynostosis (15 cases) and consisted of holocranial dismantling (complete cranial vault remodelling). Type XI included occipital and suboccipital craniectomies in multiple suture craniosynostosis (10 cases) and Type XII instances of fronto-orbital distraction (26 cases).Results. The mortality rate of the series was 2 out of 283 cases (0.7%). These 2 patients died one year after surgery. All complications were resolved without permanent deficit. Mean age at surgery was 6.75 months. According to Whitaker et al's classification, 191 patients were classified into Category I (67.49%), 51 into Category II (18.02%), 30 into Category III (10.6%) and 14 into Category IV (4.90%). Regarding to craniofacial conformation, 85.5 % of patients were considered as a good result and 15.5% of patients as a poor result. Of the patients with poor results, 6.36% were craniofacial syndromes, 2.12% had anterior plagiocephaly and 1.76% belonged to non-syndromic craniosynostosis.The most frequent complication was postoperative hyperthermia of undetermined origin (13.43% of the cases), followed by infection (7.5%), subcutaneous haematoma (5.3%), dural tears (5%), and CSF leakage (2.5%). The number of complications was higher in the group of re-operated patients (12.8% of all). In this subset of reoperations, i...

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Section: Complicationssupporting

confidence: 84%

Section: Complicationssupporting

confidence: 58%

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Surgical treatment of isolated and syndromic craniosynostosis. Results and complications in 283 consecutive cases

et al. 2008

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“…Collecting autologous tissue, however, places a significant burden on donor sites, and invariable absorption of the transplanted autografts often leads to treatment failure (7,8). Moreover, owing to the limited amount of available autografts, severe craniofacial anomalies such as Treacher Collins syndrome and Nager syndrome still remain incurable (9,10). The implantation of synthetic materials is associated with a number of potential complications, such as inflammation, extrusion, calcification, and abnormal skin (5,6).…”

mentioning

confidence: 99%

Reconstruction of human elastic cartilage by a CD44 ⁺ CD90 ⁺ stem cell in the ear perichondrium

Kobayashi

Takebe²,

Inui³

et al. 2011

Proc. Natl. Acad. Sci. U.S.A.

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Despite the great demands for treating craniofacial injuries or abnormalities, effective treatments are currently lacking. One promising approach involves human elastic cartilage reconstruction using autologous stem/progenitor populations. Nevertheless, definitive evidence of the presence of stem cells in human auricular cartilage remains to be established. Here, we demonstrate that human auricular perichondrium, which can be obtained via a minimally invasive approach, harbors a unique cell population, termed as cartilage stem/progenitor cells (CSPCs). The clonogenic progeny of a single CD44 + CD90 + CSPC displays a number of features characteristic of stem cells. Highly chondrogenic CSPCs were shown to reconstruct large (>2 cm) elastic cartilage after extended expansion and differentiation. CSPC-derived cartilage was encapsulated by a perichondrium layer, which contains a CD44 + CD90 + self-renewing stem/progenitor population and was maintained without calcification or tumor formation even after 10 mo. This is a unique report demonstrating the presence of stem cells in auricular cartilage. Utilization of CSPCs will provide a promising reconstructive material for treating craniofacial defects with successful long-term tissue restoration.

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“…Autologous bone grafting provides a rich amount of native tissue that has a high possibility of osseous integration with little risk of rejection or infection longterm, in addition to safety and security (Manson et al, 1986). Although autogenous bone is the ideal material to primarily reconstruct large skull bone defects (Barone & Jimenez, 1997;Goodrich et al, 1992;Weber et al, 1987), it has some drawbacks in reconstruction including donor site morbidity, prolonged operating times, limited availability, and difficulty to contour (Nickell et al, 1972;Whitaker et al, 1979;Jackson et al, 1983). In the pediatric surgery, bone grafts may be relatively easily contoured and curved while, in adults, it is often difficult to achieve the precise three dimensional contours normally found in the cranio-orbital region (Ducic, 2001).…”

Section: Bioactive Glass In Dental Surgery and Cranio-maxillofacial Amentioning

confidence: 99%

Development and Applications of Varieties of Bioactive Glass Compositions in Dental Surgery, Third Generation Tissue Engineering, Orthopaedic Surgery and as Drug Delivery System

Nandi¹,

Kundu²,

Datta³

2011

Biomaterials Applications for Nanomedicine

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Combined Report of Problems and Complications in 793 Craniofacial Operations

Cited by 251 publications

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Surgical treatment of isolated and syndromic craniosynostosis. Results and complications in 283 consecutive cases

Surgical treatment of isolated and syndromic craniosynostosis. Results and complications in 283 consecutive cases

Reconstruction of human elastic cartilage by a CD44 ⁺ CD90 ⁺ stem cell in the ear perichondrium

Development and Applications of Varieties of Bioactive Glass Compositions in Dental Surgery, Third Generation Tissue Engineering, Orthopaedic Surgery and as Drug Delivery System

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Combined Report of Problems and Complications in 793 Craniofacial Operations

Cited by 251 publications

References 0 publications

Surgical treatment of isolated and syndromic craniosynostosis. Results and complications in 283 consecutive cases

Surgical treatment of isolated and syndromic craniosynostosis. Results and complications in 283 consecutive cases

Reconstruction of human elastic cartilage by a CD44 + CD90 + stem cell in the ear perichondrium

Development and Applications of Varieties of Bioactive Glass Compositions in Dental Surgery, Third Generation Tissue Engineering, Orthopaedic Surgery and as Drug Delivery System

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Reconstruction of human elastic cartilage by a CD44 ⁺ CD90 ⁺ stem cell in the ear perichondrium