Our Summary

This research paper is looking at two surgical procedures used to correct certain facial abnormalities in children: the Le Fort III and the Monobloc. Both techniques involve a device that gradually shifts the bones of the face forward (a process known as distraction osteogenesis). However, there are some key differences between the two techniques, and the study aimed to compare these.

The researchers looked at data from 72 children who had these procedures at 11 different hospitals. They found that the Monobloc procedure was more commonly used in younger children, who were also more likely to have other health issues like breathing difficulties and high pressure in the brain. These children also needed more blood transfusions during their surgery.

The Monobloc procedure also led to a longer stay in the intensive care unit (ICU) and overall hospital stay, compared to the Le Fort III procedure. Complications during or after the surgery were also more common in the Monobloc group.

In summary, the Monobloc procedure seems to be associated with more risks and a longer recovery period. However, the study doesn’t say whether one procedure is better than the other overall, as this likely depends on the individual child’s situation.

FAQs

  1. What are the Le Fort III and Monobloc surgical procedures used for?
  2. What are the main differences between the Monobloc and Le Fort III procedures, based on the study?
  3. Does the study conclude which procedure, Le Fort III or Monobloc, is better overall?

Doctor’s Tip

A helpful tip a doctor might tell a patient about craniofacial surgery is to carefully weigh the risks and benefits of different surgical techniques, and to discuss these with the surgical team to make an informed decision about the best approach for the patient’s specific condition. It’s important to ask questions, understand the potential complications, and follow all pre- and post-operative instructions to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for craniofacial surgery include those with severe facial abnormalities, such as craniosynostosis, cleft lip and palate, facial asymmetry, or other congenital conditions affecting the bones and soft tissues of the face. These patients may experience difficulties with breathing, eating, hearing, vision, or speech due to their facial deformities, and craniofacial surgery can help improve their quality of life and overall function. Additionally, patients with traumatic facial injuries or tumors affecting the face may also benefit from craniofacial surgery to restore facial aesthetics and function.

Timeline

Before craniofacial surgery:

  1. Patient undergoes consultations with a craniofacial surgeon to discuss the procedure and determine the best course of action.
  2. Pre-operative tests and evaluations are conducted to ensure the patient is healthy enough for surgery.
  3. Patient may undergo orthodontic treatment to prepare the teeth and jaws for surgery.
  4. Patient and their family receive counseling and education on what to expect during and after the surgery.

After craniofacial surgery:

  1. Patient is closely monitored in the intensive care unit (ICU) immediately after surgery.
  2. Patient may experience pain, swelling, and bruising in the facial area, which is managed with pain medications.
  3. Patient may have drains and tubes in place to help with fluid drainage.
  4. Patient begins the recovery process, which includes physical therapy, speech therapy, and follow-up appointments with the surgical team.
  5. Patient may need to wear a facial splint or other devices to support the healing bones.
  6. Patient and their family receive ongoing support and guidance throughout the healing process.

What to Ask Your Doctor

  1. What specific facial abnormalities does my child have that require craniofacial surgery?
  2. What are the potential risks and complications associated with the Le Fort III and Monobloc procedures?
  3. What is the expected recovery time for each procedure?
  4. How will the distraction osteogenesis process work and what are the expected outcomes?
  5. Are there any alternative treatment options available for my child’s condition?
  6. How many surgeries of this type have you performed, and what is your success rate?
  7. Will my child need any additional treatments or therapies after the surgery?
  8. How will the surgery impact my child’s facial appearance and overall quality of life?
  9. What kind of follow-up care will be necessary after the surgery?
  10. Are there any long-term effects or risks associated with the surgery that I should be aware of?

Reference

Authors: Glover CD, Fernandez AM, Huang H, Derderian C, Binstock W, Reid R, Dalesio NM, Zhong J, Stricker PA; Pediatric Craniofacial Collaborative Group. Journal: Paediatr Anaesth. 2018 Aug;28(8):710-718. doi: 10.1111/pan.13418. Epub 2018 Jun 19. PMID: 29920872