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Subcranial approach in pediatric craniofacial surgery
Jorge Ciechomski1, Ruben Aufgang, Lucrecia Villanueva
1Plastic Surgery Unit, Hospital de Niños "Ricardo Gutierrez," Ciudad Autonoma de Buenos Aires, Argentina.
Craniomaxillofacial Trauma & Reconstruction
|December 2, 2011
Summary
The subcranial approach offers excellent surgical exposure for pediatric frontoethmoidal orbital injuries, with reduced operative time and hospital stays compared to traditional methods.
Area of Science:
- Pediatric Plastic Surgery
- Neurosurgery
- Ophthalmology
Background:
- The subcranial approach, initially for fractures, is adapted for pediatric frontoethmoidal region lesions.
- Nontraumatic injuries present unique surgical challenges in pediatric patients.
Purpose of the Study:
- Evaluate the efficacy and safety of the subcranial approach for pediatric nontraumatic frontoethmoidal orbital injuries.
- Compare outcomes with conventional frontal craniotomy.
Main Methods:
- Retrospective case series of nine pediatric patients undergoing subcranial approach for various frontoethmoidal orbital lesions.
- Detailed analysis of surgical outcomes, complications, cosmetic results, and facial growth.
Main Results:
- Excellent surgical exposure achieved in all cases with no cosmetic defects.
- Shorter operative times and hospitalizations compared to frontal craniotomy.
- One mortality (stroke), one recurrence (meningioma), and two infections (one requiring hardware removal).
Conclusions:
- The subcranial approach is a viable and effective option for pediatric nontraumatic frontoethmoidal orbital injuries.
- It offers advantages in terms of operative time, hospitalization, and cosmetic outcomes.
- Careful patient selection and monitoring are crucial to mitigate potential complications.
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