30-year International Pediatric Craniofacial Surgery Partnership: Evolution from the “Third World” Forward
نویسندگان
چکیده
BACKGROUND Craniofacial diseases constitute an important component of the surgical disease burden in low- and middle-income countries. The consideration to introduce craniofacial surgery into such settings poses different questions, risks, and challenges compared with cleft or other forms of plastic surgery. We report the evolution, innovations, and challenges of a 30-year international craniofacial surgery partnership. METHODS We retrospectively report a partnership between surgeons at the Uniwersytecki Szpital Dzieciecy in Krakow, Poland, and a North American craniofacial surgeon. We studied patient conditions, treatment patterns, and associated complications, as well as program advancements and limitations as perceived by surgeons, patient families, and hospital administrators. RESULTS Since partnership inception in 1986, the complexity of cases performed increased gradually, with the first intracranial case performed in 1995. In the most recent 10-year period (2006-2015), 85 patients have been evaluated, with most common diagnoses of Apert syndrome, Crouzon syndrome, and single-suture craniosynostosis. In the same period, 55 major surgical procedures have been undertaken, with LeFort III midface distraction, posterior vault distraction, and frontoorbital advancement performed most frequently. Key innovations have been the employment of craniofacial distraction osteogenesis, the use of Internet communication and digital photography, and increased understanding of how craniofacial morphology may improve in the absence of surgical intervention. Ongoing challenges include prohibitive training pathways for pediatric plastic surgeons, difficulty in coordinating care with surgeons in other institutions, and limited medical and material resources. CONCLUSION Safe craniofacial surgery can be introduced and sustained in a resource-limited setting through an international partnership.
منابع مشابه
Clinical features and treatment of pediatric orbit fractures.
PURPOSE To describe a series of orbital fractures and associated ophthalmic and craniofacial injuries in the pediatric population. METHODS A retrospective case series of 312 pediatric patients over a 9-year period (2002-2011) with orbit fractures diagnosed by CT. RESULTS Five hundred ninety-one fractures in 312 patients were evaluated. There were 192 boys (62%) and 120 girls (38%) with an a...
متن کاملCraniofacial Fibrous Dysplasia of Zygomaticomaxillary Complex
Fibrous dysplasia is a benign bone disease first described by Lichtenstein in 1938. It is characterized by progressive replacement of normal bone with fibro-osseous connective tissue. When the disease involves craniofacial skeleton, it results in significant disfigurement and other functional problems. This paper reports a case of large craniofacial fibrous dysplasia involving zygomaticomaxilla...
متن کاملOutcome of craniofacial surgery in children and adolescents with malignant tumors involving the skull base: an international collaborative study.
BACKGROUND The aim of the study was to characterize the distribution of anterior skull base (ASB) cancers in the pediatric population and to identify predictors of outcome. METHODS This was an international study of 1307 patients undergoing craniofacial surgery for malignant tumors; 6.4% (n = 84) among these were <or=21 years old. RESULTS The most common histologic type was sarcoma (40%), f...
متن کامل25(th) anniversary state-of-the-art expert discussion with Steven S. Rothenberg, MD, on the evolution of thoracic surgery.
Dr. Steven S. Rothenberg is the Chief of Pediatric Surgery at the Rocky Mountain Hospital for Children at Presbyterian/St. Luke’s in Denver, CO. He is also a Clinical Professor of Surgery at Columbia University College of Physicians and Surgeons (New York, NY). He is a world leader in the field of endoscopic surgery in infants and children and has pioneered many of the procedures using minimall...
متن کامل