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Soft-Tissue Response Rate to Chin Skeletal Advancement in Patients with Lower Facial Burn Scar

As’adi, Kamran M.D.; Salehi, Seyed Hamid M.D.; Shoar, Saeed M.D.; Guyuron, Bahman M.D.

Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0000000000000131
Reconstructive: Head and Neck: Original Articles
Abstract

Background: This study aimed to evaluate the long-term outcomes and the soft-tissue response to osseous genioplasty in patients with chin retrusion caused by early life facial burn injury.

Methods: Twenty-two consecutive patients with retrusive chin as a result of severe childhood facial burn were included in this study. Cephalometric analysis and photographs were used to assess the patients for eligibility of a surgical correction. Horizontal hard-tissue advancement and soft-tissue responses were measured as the primary outcomes at the early and late postoperative follow-up visits.

Results: A total of 22 patients fulfilled the study requirements. Average preoperative distance between the pogonion, as the most anterior point of the anterior mandibular contour, and a perpendicular line connecting the nasion and the supramental point of the mandible was 0.82 ± 1.1 mm, which increased significantly to 7.8 ± 0.8 mm after genioplasty (p < 0.0001). Soft tissue was repositioned on average 6.1 ± 0.4 mm anteriorly on average, which is in comparison with the amount of chin skeleton advancement, and a response ratio of 0.8:1 was calculated at late follow-up.

Conclusion: Burn-related retrusive chin can appropriately be treated with sliding osseous genioplasty and will require slight overcorrection compared with patients without a history of lower face burn.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Author Information

Tehran, Iran; and Cleveland, Ohio

From the Department of Plastic and Reconstructive Surgery, St. Fatima Hospital, the Department of General Surgery, Motahari Burn Hospital, and the Department of Surgery, Shariati Hospital, Iran University of Medical Sciences; and the Department of Plastic Surgery, Case Western Reserve University.

Received for publication August 22, 2013; accepted November 6, 2013.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Bahman Guyuron, M.D., 29017 Cedar Road, Cleveland (Lyndhurst), Ohio 44124, bahman.guyuron@gmail.com

©2014American Society of Plastic Surgeons