Perioperative outcomes and management in midface advancement surgery: a multicenter observational descriptive study from the Pediatric Craniofacial Collaborative Group. Issue 8 (19th June 2018)

• Record Type: Journal Article
• Authors: Glover, Chris D.; Fernandez, Allison M.; Huang, Henry; Derderian, Christopher; Binstock, Wendy; Reid, Russell; Dalesio, Nicholas M.; Zhong, John; Stricker, Paul A.
• Other Names: Abruzzese Christopher investigator.; Apuya Jesus investigator.; Beethe Amy investigator.; Benzon Hubert investigator.; Brzenski Alyssa investigator.; Budac Stefan investigator.; Busso Veronica investigator.; Chiao Franklin investigator.; Cladis Franklyn investigator.; Claypool Danielle investigator.; Collins Michael investigator.; Falcon Ricardo investigator.; Fernandez Patrick investigator.; Fiadjoe John investigator.; Gangadharan Meera investigator.; Gentry Katherine investigator.; Goobie Susan investigator.; Gosman Amanda investigator.; Grap Shannon investigator.; Gries Heike investigator.; Griffin Allison investigator.; Haberkern Charles investigator.; Hajduk John investigator.; Hall Rebecca investigator.; Hansen Jennifer investigator.; Hetmaniuk Mali investigator.; Hsieh Vincent investigator.; Ingelmo Pablo investigator.; Ivanova Iskra investigator.; Jain Ranu investigator.; Kars Michelle investigator.; Kowalczyk‐Derderian Courtney investigator.; Kugler Jane investigator.; Labovsky Kristen investigator.; Lakheeram Indrani investigator.; Lee Andrew investigator.; Martinez Jose Luis investigator.; Masel Brian investigator.; Medellin Eduardo investigator.; Meier Petra investigator.; Levy Heather Mitzel investigator.; Muhly Wallis T. investigator.; Muldowney Bridget investigator.; Nelson Jonathon investigator.; Nicholson Julie investigator.; Nguyen Kim‐Phuong investigator.; Nguyen Thanh investigator.; Olutuye Olutoyin A. investigator.; Owens‐Stubblefield Margaret investigator.; Parekh Uma Ramesh investigator.; Petersen Timothy investigator.; Pohl Vanessa investigator.; Poteet‐Schwartz Kim investigator.; Prozesky Jansie investigator.; Reddy Srijaya investigator.; Ricketts Karene investigator.; Rubens Daniel investigator.; MD Laura Ryan investigator.; Skitt Rochelle investigator.; Soneru Codruta investigator.; Spitznagel Rachel investigator.; Singh Davinder investigator.; Singhal Neil R. investigator.; Sorial Emad investigator.; Staudt Susan investigator.; Stubbeman Bobbie investigator.; Sung Wai investigator.; Syed Tariq investigator.; Szmuk Peter investigator.; Taicher Brad M. investigator.; Thompson Douglas investigator.; RN Lisa Tretault investigator.; Ungar‐Kastner Galit investigator.; Watts Rheana investigator.; Wieser John investigator.; Wong Karen investigator.; Zamora Lillian investigator.;
• Is Part Of: Paediatric anaesthesia. Volume 28:Issue 8(2018:Aug.)
• Page Start: 710
• Page End: 718
• Publication Date: 2018-06-19
• Subjects: craniofacial abnormalities -- craniosynostoses -- Le Fort osteotomy -- midface hypoplasia -- outcomes -- pediatrics -- registries; Pediatric anesthesia -- Periodicals; 617.96798
• DOI: 10.1111/pan.13418
• Languages: English
• ISSNs: 1155-5645

Abstract

Summary: Background/Aims: The evolution of Le Fort III and Monobloc procedures with utilization of distraction devices has resulted in shortened surgical times, greater facial advancements, and decreased transfusion requirements. The aim of this observational study was to utilize data from the multicenter Pediatric Craniofacial Surgery Perioperative Registry to present and compare patient characteristics and outcomes in children undergoing midface advancement with distraction osteogenesis. Methods: We queried the Pediatric Craniofacial Surgery Perioperative Registry for children undergoing midface advancement involving distractor application from June 2012 to September 2016. Data extracted included demographics, perioperative management, complications, fluid and transfusion volumes, and length of stay. The extracted patient characteristics and perioperative variables were summarized and compared. Results: The query yielded 72 cases from 11 institutions: 49 children undergoing Le Fort III and 23 undergoing Monobloc procedures. Monobloc patients were younger, weighed less, and more likely to have tracheostomies along with elevated intracranial pressure. Greater transfusion was observed in the Monobloc group for nearly all of the transfusion outcomes evaluated. Median ICU and hospital length of stay were 2 and 3 days longer, respectively, in the Monobloc group. Perioperative complications were not uncommon, occurring in 18% of patients in the Le Fort III group and 30% in the Monobloc group. Conclusion: Monobloc procedures were associated with greater transfusion and longer ICU and hospital length of stay. Perioperative complications were more prevalent in the Monobloc group.