Age-dependent closure of bony defects after frontal orbital advancement.

Abstract:

BACKGROUND:The ability of the immature skull to spontaneously heal large bony defects created after craniofacial procedures was examined over a 25-year period of craniofacial surgery at the Children's Hospital of Philadelphia. METHODS:Only patients who underwent frontal orbital advancement and reconstruction, had at least 1 year of documented follow-up, and had the presence or absence of a bony defect documented on clinical examination were included. The sex, age at operation, diagnosis, history of a prior craniectomy, and presence or absence of a postoperative infection were determined for each patient. A variety of statistics were applied to the data. RESULTS:Eighty-one patients met the inclusion criteria. A statistically significant association between age at operation and closure of bony defect was demonstrated. Children who closed a bony defect after frontal orbital advancement and reconstruction were significantly younger than those children who had a persistent bony defect. Iterative regression analyses demonstrated that a transition point between closure and the inability to close bony defects occurred between 9 and 11 months of age. Closure of bony defects was not statistically associated with sex, prior craniectomy, an FGFR mutation, or a postoperative infection in the regression analysis. CONCLUSIONS:Healing of bony defects after frontal orbital advancement and reconstruction is significantly related to age at initial operation, with a mean age for closure of less than 12 months. Between 9 and 11 months of age, a change occurs that results in an increasingly lower probability of bony defect closure; thus, all other considerations being equal, initial frontal orbital advancement and reconstruction would ideally take place before this occurs.

journal_name

Plast Reconstr Surg

authors

Paige KT,Vega SJ,Kelly CP,Bartlett SP,Zakai E,Jawad AF,Stouffer N,Whitaker LA

doi

10.1097/01.prs.0000232353.44086.af

subject

Has Abstract

pub_date

2006-09-15 00:00:00

pages

977-984

issue

4

eissn

0032-1052

issn

1529-4242

pii

00006534-200609150-00022

journal_volume

118

pub_type

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