Faculty Collaboration Database

Perioperative outcomes and management in midface advancement surgery: a multicenter observational descriptive study from the Pediatric Craniofacial Collaborative Group. Paediatr Anaesth 2018 Aug;28(8):710-718

Date

06/20/2018

Pubmed ID

29920872

DOI

10.1111/pan.13418

Scopus ID

2-s2.0-85052203117 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

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.

Author List

Glover CD, Fernandez AM, Huang H, Derderian C, Binstock W, Reid R, Dalesio NM, Zhong J, Stricker PA, Pediatric Craniofacial Collaborative Group

Author

Kristen Labovsky MD Assistant Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Blood Transfusion
Child
Child, Preschool
Craniofacial Abnormalities
Craniosynostoses
Female
Frontal Bone
Humans
Infant
Intraoperative Care
Intraoperative Complications
Male
Maxilla
Osteogenesis, Distraction
Osteotomy, Le Fort
Perioperative Period
Postoperative Complications
Registries
Treatment Outcome