Analysis of complications following multidisciplinary functional intervention in paediatric craniomaxillofacial deformities

F Hariri; M F Abdullah; K B C Adam; N F A Bahuri; J Kulasegarah; A M Nathan; F Ismail; N Khaliddin; C M May; L Chan; T M Keong; D Ganesan; Z A A Rahman

doi:10.1016/j.ijom.2020.08.002

Analysis of complications following multidisciplinary functional intervention in paediatric craniomaxillofacial deformities

Int J Oral Maxillofac Surg. 2021 Apr;50(4):457-462. doi: 10.1016/j.ijom.2020.08.002. Epub 2020 Sep 3.

Authors

F Hariri¹, M F Abdullah², K B C Adam³, N F A Bahuri⁴, J Kulasegarah⁵, A M Nathan⁶, F Ismail⁷, N Khaliddin⁷, C M May⁷, L Chan⁸, T M Keong⁶, D Ganesan⁴, Z A A Rahman⁸

Affiliations

¹ Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: firdaushariri@um.edu.my.
² Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia; School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
³ Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia; Department of Oral Maxillofacial Surgery and Diagnosis, Kulliyyah of Dentistry, IIUM Kuantan Campus, Kuantan, Malaysia.
⁴ Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁵ Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁶ Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁷ Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁸ Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.

PMID: 32891466
DOI: 10.1016/j.ijom.2020.08.002

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.

Keywords: Complications; Craniofacial deformities; Craniofacial surgery; Craniomaxillofacial; Morbidity.

MeSH terms

Child
Craniofacial Abnormalities* / surgery
Humans
Osteogenesis, Distraction*
Retrospective Studies