Our Summary

This research paper looks at patients with Treacher Collins syndrome and some cases of bilateral craniofacial microsomia, conditions that often lead to blockages in the airways due to underdeveloped and twisted facial bones. These patients often rely on a tracheostomy (a surgical hole in the windpipe for breathing) even after multiple surgeries to clear the airways. The study examines a procedure called counterclockwise craniofacial distraction osteogenesis, which aims to correct the facial bone deformity and expand the upper airway by rotating certain facial bones around the nose and forehead area. Early results from this operation show significant increases in airway volumes and successful removal of tracheostomy in most patients.

FAQs

  1. What conditions are often associated with blockages in the airways due to underdeveloped and twisted facial bones?
  2. What is counterclockwise craniofacial distraction osteogenesis and how does it help patients with Treacher Collins syndrome and bilateral craniofacial microsomia?
  3. What are the early results of the counterclockwise craniofacial distraction osteogenesis procedure?

Doctor’s Tip

A doctor might tell a patient considering craniofacial surgery that it can greatly improve their quality of life by correcting facial bone deformities and expanding their airways, potentially eliminating the need for a tracheostomy. It is important for the patient to carefully follow post-operative care instructions to ensure the best possible outcome. Additionally, discussing the specific benefits and risks of the surgery with a qualified craniofacial surgeon is crucial in making an informed decision.

Suitable For

Other types of patients who may be recommended for craniofacial surgery include those with cleft lip and palate, craniosynostosis (premature fusion of skull bones), facial trauma, facial tumors, facial asymmetry, and other congenital or acquired craniofacial anomalies. These surgeries aim to improve facial appearance and function, restore facial symmetry, correct breathing or feeding difficulties, and enhance overall quality of life. The decision to undergo craniofacial surgery is typically made after careful evaluation by a multidisciplinary team of specialists, including plastic surgeons, oral and maxillofacial surgeons, otolaryngologists, pediatricians, and other healthcare providers.

Timeline

Before craniofacial surgery:

  • Patient is diagnosed with Treacher Collins syndrome or bilateral craniofacial microsomia
  • Patient may have difficulty breathing due to underdeveloped and twisted facial bones
  • Patient may rely on a tracheostomy for breathing
  • Patient undergoes various surgeries to clear airways but may still have breathing difficulties

After craniofacial surgery:

  • Patient undergoes counterclockwise craniofacial distraction osteogenesis procedure
  • Facial bones are rotated around the nose and forehead area to correct deformities
  • Airway volumes increase significantly
  • Tracheostomy is successfully removed in most patients
  • Patient experiences improved breathing and quality of life after surgery.

What to Ask Your Doctor

  1. What specific facial bone deformities will this surgery address?

  2. How will the counterclockwise craniofacial distraction osteogenesis procedure be performed?

  3. What are the potential risks and complications associated with this surgery?

  4. How long is the recovery period after the surgery, and what can I expect during this time?

  5. Will I need additional surgeries or procedures in the future following this operation?

  6. How likely is it that this surgery will successfully expand my airway and allow for the removal of the tracheostomy?

  7. What kind of long-term outcomes can I expect from this surgery in terms of breathing and facial appearance?

  8. Are there any lifestyle changes or accommodations I will need to make post-surgery?

  9. What kind of follow-up care and monitoring will be necessary after the surgery?

  10. Are there any alternative treatment options for my condition that I should consider before proceeding with this surgery?

Reference

Authors: Hopper RA, Wang HD, Mercan E, Kapadia H. Journal: Clin Plast Surg. 2021 Jul;48(3):445-454. doi: 10.1016/j.cps.2021.02.006. Epub 2021 May 5. PMID: 34051897