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Parry-Romberg Reconstruction: Optimal Timing for Hard and Soft Tissue Procedures

Slack, Ginger C. BS; Tabit, Christina J. BA; Allam, Karam A. MD; Kawamoto, Henry K. MD, DDS; Bradley, James P. MD

Journal of Craniofacial Surgery:
doi: 10.1097/SCS.0b013e318258bd11
Original Articles
Abstract

Abstract: For the treatment of Parry-Romberg syndrome or progressive hemifacial atrophy, we studied 3 controversial issues: (1) optimal timing, (2) need for skeletal reconstruction, and (3) need for soft tissue (medial canthus/lacrimal duct) reconstruction. Patients with Parry-Romberg syndrome (>5 y follow-up) were divided into 2 groups: (1) younger than 14 years and (2) 14 years or older (n = 43). Sex, age, severity of deformity, number of procedures, operative times, and augmentation fat volumes were recorded. Physician and patient satisfaction surveys (5-point scale) were obtained, preoperative and postoperative three-dimensional computed tomographic scans were reviewed, and a digital three-dimensional photogrammetry system was used to determine volume retention. Our results indicate that the younger patient group required more procedures compared with the older patient group (4.3 versus 2.8); however, the younger group had higher patient/family satisfaction scores (3.8 versus 3.0). Skeletal and soft tissue reconstruction resulted in improved symmetry score (60% preoperatively to 93% final) and satisfaction scores (3.4 preoperatively to 3.8 final). Patients with Parry-Romberg syndrome required multiple corrective surgeries but showed improvements even when beginning before puberty. Soft and hard tissue reconstruction was beneficial.

Author Information

From the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, University of California, Los Angeles, California.

Received April 2, 2012.

Accepted for publication April 2, 2012.

Address correspondence and reprint requests to James P. Bradley, MD, Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, University of California, Los Angeles, 200 UCLA Medical Plaza, Suite 465, Los Angeles, CA 90095; E-mail: Bradley.research@gmail.com

This paper was presented at PSRC 2011 in Louisville, KY.

The authors report no conflicts of interest.

© 2012 Mutaz B. Habal, MD