Journal of Craniofacial Surgery

Skip Navigation LinksHome > November 2012 - Volume 23 - Issue 7 > Parry-Romberg Reconstruction: Optimal Timing for Hard and S...
Journal of Craniofacial Surgery:
doi: 10.1097/SCS.0b013e318258bd11
Original Articles

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

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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.

© 2012 Mutaz B. Habal, MD

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