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Analysis of complications following multidisciplinary functional intervention in paediatric craniomaxillofacial
F Hariri1, M F Abdullah2, K B C Adam3
1Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
Insights
This study analyzed complications in pediatric craniomaxillofacial (CMF) surgery, finding most were minor. Complex definitive interventions showed higher complication rates, emphasizing the need for multidisciplinary CMF care.
Area of Science:
- Pediatric Surgery
- Craniofacial Surgery
- Medical Complications Analysis
Background:
- Paediatric craniomaxillofacial (CMF) surgery demands a multidisciplinary approach for managing craniofacial deformities.
- A comprehensive understanding of intervention-related complications is crucial for optimizing patient outcomes.
Purpose of the Study:
- To retrospectively analyze the types and rates of complications following functional interventions in pediatric CMF deformity patients.
- To evaluate complication patterns across different intervention types within a specialized craniofacial center.
Main Methods:
- Retrospective analysis of electronic data from 34 pediatric CMF deformity patients.
- Inclusion of all patients undergoing functional interventions, categorizing 64 procedures (48 intermediate, 16 definitive).
- Complication classification using the Sharma system.
Main Results:
- Overall complication rate was analyzed, with Type I complications (e.g., local infection, tarsorrhaphy opening) being most frequent (20.3%).
- More severe complications (Types III and IV), including temporary visual loss and intraoperative hemorrhage, occurred at lower rates (1.6% each).
- Higher complication rates were noted for complex definitive interventions like monobloc distraction osteogenesis compared to intermediate ones.
Conclusions:
- While most complications in pediatric CMF surgery are manageable, serious events necessitate vigilance.
- Effective complication prevention strategies are essential to mitigate risks of permanent damage or mortality.
- A multidisciplinary team approach is vital for optimizing outcomes in pediatric CMF patient management.
Abstract:
Paediatric craniomaxillofacial (CMF) surgery requires a multidisciplinary team approach to ensure the optimal and holistic management of children with craniofacial deformities. The aim of this retrospective study was to analyse the complications following functional interventions among 34 CMF deformity patients in a single multidisciplinary craniofacial centre. Electronic data including patient demographic characteristics and clinical entry were analysed. Inclusion criteria were all paediatric patients with CMF deformities who underwent various functional interventions. A total of 64 interventions (48 intermediate and 16 definitive) were conducted. Based on the Sharma classification of complications, 20.3% were type I, 4.7% were type II, 1.6% were type III, and 4.7% were type IV . Most complications were type I, which included local infection (3.1%) and premature opening of tarsorrhaphy (3.1%). More serious complications (types III and IV) included temporary visual loss (1.6%) and intraoperative haemorrhage (1.6%). Although a low complication rate was observed in intermediate interventions, a higher complication rate was observed in more complex definitive interventions such as monobloc distraction osteogenesis. Although most complications were manageable, effective prevention remains mandatory, as serious complications may lead to permanent damage and mortality. This analysis highlights the importance of a multidisciplinary team approach to optimize the outcomes in CMF patient management.
