PURPOSE: The purpose of this study was to document the early and late complications associated with frontofacial distraction. METHOD: A systematic review of the literature on complications in craniofacial surgery and a review of records of patients undergoing frontofacial distraction at Great Ormond Street Hospital for Children over a 10-year period were conducted. RESULTS: Complications arising from frontofacial advancement are common. Mortality rates varied between 0 and 4.5 %. There has been a general decline in reported mortality rates with time, and the most recent series report mortalities of less than 1 %. The incidence of significant blood loss (greater than one blood volume) in patients undergoing monobloc osteotomy varied between 5.3 and 9.1 %. CSF leaks following monobloc distraction are common (incidence, 2-20 %). Most of these leaks settle spontaneously. The incidence of frontal bone flap necrosis requiring debridement and a subsequent cranioplasty varied between 3 and 20 %. CONCLUSIONS: The functional and aesthetic benefits of frontofacial distraction are well documented, but these advantages are associated with a significant complication rate. The potential benefits of frontofacial distraction need to be carefully weighed against the potential complications when deciding to recommend surgery.
PURPOSE: The purpose of this study was to document the early and late complications associated with frontofacial distraction. METHOD: A systematic review of the literature on complications in craniofacial surgery and a review of records of patients undergoing frontofacial distraction at Great Ormond Street Hospital for Children over a 10-year period were conducted. RESULTS: Complications arising from frontofacial advancement are common. Mortality rates varied between 0 and 4.5 %. There has been a general decline in reported mortality rates with time, and the most recent series report mortalities of less than 1 %. The incidence of significant blood loss (greater than one blood volume) in patients undergoing monobloc osteotomy varied between 5.3 and 9.1 %. CSF leaks following monobloc distraction are common (incidence, 2-20 %). Most of these leaks settle spontaneously. The incidence of frontal bone flap necrosis requiring debridement and a subsequent cranioplasty varied between 3 and 20 %. CONCLUSIONS: The functional and aesthetic benefits of frontofacial distraction are well documented, but these advantages are associated with a significant complication rate. The potential benefits of frontofacial distraction need to be carefully weighed against the potential complications when deciding to recommend surgery.
Authors: L A Whitaker; I R Munro; K E Salyer; I T Jackson; F Ortiz-Monasterio; D Marchac Journal: Plast Reconstr Surg Date: 1979-08 Impact factor: 4.730
Authors: Helen Witherow; David Dunaway; Robert Evans; Ken K Nischal; Caroleen Shipster; Valerie Pereira; Daniella Hearst; Michelle White; Barry M Jones; Richard Hayward Journal: Plast Reconstr Surg Date: 2008-04 Impact factor: 4.730
Authors: Helen Witherow; Filip Thiessen; Robert Evans; Barry M Jones; Richard Hayward; David Dunaway Journal: J Craniofac Surg Date: 2008-01 Impact factor: 1.046
Authors: J G McCarthy; S B Glasberg; C B Cutting; F J Epstein; B H Grayson; G Ruff; C H Thorne; J Wisoff; B M Zide Journal: Plast Reconstr Surg Date: 1995-08 Impact factor: 4.730