Facial asymmetry persists despite surgery to correct congenital deformity

February 26, 2008

PROVIDENCE, R.I. - Adults and teens that underwent surgery as infants to correct a congenital condition that causes the forehead and face to appear uneven still have a degree of facial asymmetry years later, according to new research led by a Hasbro Children's Hospital surgeon.

The study, published in the February issue of Plastic and Reconstructive Surgery, focused on unilateral coronal synostosis, a type of craniosynostosis, in which the bones of the skull on one side of the head fuse prematurely. Craniosynostosis, or early fusion of the cranial sutures, affects 1 in 2000 live births. During corrective surgery, known as fronto-orbital advancement, surgeons remove and reshape the bones of the forehead and upper eye sockets, replacing them in a more normal anatomic position. This is typically performed during infancy.

"Although there appears to be some lingering asymmetry years after many of these patients underwent corrective surgery, most patients and their families don't notice these differences, which do not appear to pose any significant health risks," said lead author Albert Oh, M.D., director of the craniofacial surgery program at Hasbro Children's Hospital. "Nevertheless, it's important that we understand more about this asymmetry, which could lead to improvements of the operation and further our knowledge regarding the cause of craniosynostosis."

Oh, who's also an assistant professor in the department of surgery at The Warren Alpert Medical School of Brown University, led this research while at Children's Hospital Boston and Harvard Medical School.

In the study, Oh and colleagues used three-dimensional photo technology known as photogrammetry to digitally measure the faces of adult and adolescent patients with unilateral coronal synostosis who had undergone corrective surgery during infancy. They focused on different measurements comparing one side of the face to the other.

The researchers observed that average measurements on the side of the face affected by unilateral coronal synostosis were invariably shorter in comparison to the opposite side. They also found consistent rotation of the nose and facial midline away from the side of the fusion. Interestingly, the severity of long-term postoperative facial symmetry did not depend on either age at surgery or age at follow-up.

"While this study conclusively documented persistent postoperative facial asymmetry, our study group of 15 patients was relatively small. What is really needed is a long-term prospective study comparing preoperative and postoperative facial measurements," said Oh.
-end-
Study co-authors were John B. Mulliken, M.D.; Julielynn Wong, M.D.; Eiichi Ohta, M.D.; Gary F. Rogers M.D.; and Curtis K. Deutsch, M.D., all associated with Children's Hospital Boston. The photogrammetric device used in the study - the 3dMDface system - was funded in part by a grant from the National Center for Research Resources, National Institutes of Health, to the Children's Hospital Boston General Clinical Research Center.

Hasbro Children's Hospital (www.hasbrochildrenshospital.org) in Providence, RI, is the pediatric division of Rhode Island Hospital, the largest teaching hospital of The Warren Alpert Medical School of Brown University. A private, not-for-profit hospital, it is nationally recognized for its child protection program and Draw-A-Breath asthma and allergy initiative. It is also the home of the Injury Prevention Center, which aims to reduce accidental injuries in children, as well as the region's only pediatric imaging center. The hospital has pioneered numerous procedures and is at the forefront of fetal surgery, orthopedics and pediatric neurosurgery. Hasbro Children's Hospital is a member of the Lifespan health system.

Lifespan

Related Surgery Articles from Brightsurf:

Decision conflict before cancer surgery correlates with lower activity after surgery
Nearly one-third of cancer patients who decide to undergo surgery for their condition may have second thoughts, and this decision conflict may lead to less favorable treatment outcomes in both the near- and long-term, according to a team of investigators at Massachusetts General Hospital and Ariadne Labs.

Examining association between weight loss before bariatric surgery, risk of death after surgery
Researchers looked at whether a patient's body weight and weight loss before bariatric surgery were associated with risk of death within 30 days after surgery using data from nearly 500,000 patients in the US and Canada.

Guidelines for thyroid surgery published in Annals of Surgery
The first set of comprehensive, evidence-based clinical guidelines for surgical treatment of thyroid disease -- developed by an expert panel assembled by the American Association of Endocrine Surgeons (AAES) -- was published today by Annals of Surgery.

Colorectal surgery patients use fewer opioids, report less pain with enhanced recovery after surgery
Colorectal surgery patients who were a part of an enhanced recovery after surgery (ERAS) program had less pain, while using nearly half as many opioids, according to research being presented at the ANESTHESIOLOGY® 2019 annual meeting.

Video assisted lung surgery reduces complications and hospital stays compared to open surgery
Video-assisted thoracic surgery is associated with lower in-hospital complications and shorter length of stay compared with open surgery among British patients who were diagnosed at an early stage of lung cancer, according to research presented today the IASLC 2019 World Conference on Lung Cancer, hosted by the International Association for the Study of Lung Cancer.

Most deaths related to noncardiac surgery occur after surgery and after discharge from hospital
It's not the operating room that is risky for patients undergoing noncardiac surgery; it's the recovery period.

Study looks at opioid use after knee surgery
A small study looked at whether reducing the number of opioid tablets prescribed after knee surgery would reduce postoperative use and if preoperative opioid-use education would reduce it even more.

Surgery patients are getting older every year
A new BJS (British Journal of Surgery) analysis reveals that people undergoing surgery in England are getting older at a faster rate than the general population.

Children requiring thyroid surgery have better outcomes at high-volume surgery centers
New research recently published in the Journal of Pediatric Surgery found that post-operative success rates of pediatric thyroid patients, particularly children who require a thyroidectomy, correlate with the institution's patient volume.

Do negative public attitudes toward weight loss surgery stop some patients from having surgery?
Most patients who qualify for weight loss surgery don't have the procedure despite its safety and effectiveness.

Read More: Surgery News and Surgery Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.