Artículos de revistas
Strategies For The Optimal Individualized Surgical Management Of Craniofacial Fibrous Dysplasia.
Registro en:
Annals Of Plastic Surgery. , 2015-Sep.
1536-3708
10.1097/SAP.0000000000000640
26418800
Autor
Denadai, Rafael
Raposo-Amaral, Cesar Augusto
Marques, Frederico Figueiredo
Ghizoni, Enrico
Buzzo, Celso Luiz
Raposo-Amaral, Cassio Eduardo
Institución
Resumen
The surgical management of craniofacial fibrous dysplasia is controversial. The purpose of this study was to report the surgical outcomes of individualized management of craniofacial fibrous dysplasia of a single institution. Data from patients (n = 20) with craniofacial fibrous dysplasia, who were surgically treated between 2007 and 2014, were analyzed. Surgical approach (radical or conservative surgery) was individualized according to age, craniofacial anatomical site (zones I to IV of Chen and Noordhoff), functional issues, aesthetic impairment, patients/parents' preferences, and surgical team experience. The surgical outcomes (radical surgery group versus conservative surgery group) were compared based on the age at the time of the procedure, the length of hospital stay, reoperation, recurrence and complication rates, and the Whitaker grading system. Significant (all P < 0.05) differences were observed in patients with craniofacial fibrous dysplasia who were treated with radical excision (65%) compared with those treated with limited reduction burring (35%), according to age (19.22 years versus 12.57 years), the length of hospital stay (3.56 days versus 1.29 days), recurrence (15% versus 71%), and number of subsequent procedures (1 intervention versus 2.4 interventions), respectively. The radical surgery group presented a significantly (P < 0.05) lower initial Whitaker outcome score than the conservative surgery group (1.89 and 2.57, respectively). Similar (all P > 0.05) final Whitaker outcome scores (1.56 versus 1.71) and surgical complication rates (11% versus 14%) were recorded between the treatment groups. Based on clinical experience and surgical outcomes presented in this study, the surgical approach of craniofacial fibrous dysplasia should be tailored to individual patient's needs.