Assessment and treatment of facial deformity resulting from radiation to the orbital area in childhood

Plastic and Reconstructive Surgery
I T JacksonB Audet

Abstract

Children who receive radiation for malignant tumors in the orbital area frequently develop widespread craniofacial deformities. These affect the skull, orbit, maxilla, and mandible. When these patients seek treatment at a later age, they require careful assessment using cephalometrics and three-dimensional imaging. It is recommended that the four levels of skeletal deformity be corrected in a single procedure, that is frontotemporal expansion with repositioning of the skull base area, orbital expansion and repositioning together with maxillary and mandibular surgery. Bone grafts should be inlay rather than onlay and soft tissue should be supplied by free-tissue transfer. This counteracts any residual ischemia related to the previous radiation therapy. The second surgical stage is designed to reconstruct the socket and the eyelids to allow more satisfactory rehabilitation with an ocular prosthesis. In patients who have a globe present, the usual enophthalmos can be corrected by repositioning of the eye as part of the first procedure by reducing the anteroposterior dimensions of the socket. In bilateral cases, the deformity is hourglass in nature and requires correction in the frontal and temporal area with lateral displacement o...Continue Reading

References

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Citations

Sep 5, 2009·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Kristian AquilinaRobert A Sanford
Apr 20, 2002·Plastic and Reconstructive Surgery·Christopher R ForrestCho Y Pang
Mar 6, 2003·Plastic and Reconstructive Surgery·Jeremy A Hunt, P Craig Hobar
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Mar 19, 2011·The Journal of Craniofacial Surgery·Danling YangBing Fang
Oct 2, 2008·Plastic and Reconstructive Surgery·Artur GevorgyanChristopher R Forrest
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