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Craniofacial Syndromes

Buchanan, Edward P. M.D.; Xue, Amy S. M.D.; Hollier, Larry H. Jr M.D.

Plastic and Reconstructive Surgery: July 2014 - Volume 134 - Issue 1 - p 128e–153e
doi: 10.1097/PRS.0000000000000308
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Learning Objectives: After studying this article, the participant should be able to: 1. Recognize the clinical presentations of commonly seen craniofacial syndromes. 2. Understand the most serious complications associated with each syndrome. 3. Formulate the best age-appropriate surgical plans.

Summary: Craniofacial syndromes fall into two major categories—those associated with craniosynostosis, and those associated with clefts. Each has a different set of potential complications requiring a unique approach for surgical management. Craniosynostosis is a congenital disorder in which one or more of the cranial sutures fuses prematurely. The most common syndromes associated with this condition include Crouzon, Apert, Pfeiffer, Muenke, and Saethre-Chotzen syndromes. Surgical management of these children requires a multidisciplinary approach and close involvement of the family. Operations must take into consideration the growing potential of the bony structures. Common syndromes associated with clefts include Pierre Robin, Treacher Collins, Nager, Binder, and Stickler syndromes. Many of these children have severe airway issues requiring immediate address before operative reconstruction. As with syndromes associated with craniosynostosis, the key to management is a multidisciplinary approach focused on the right timing. The purpose of this article is to review the clinical presentation, care, and treatment of these patients.

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Houston, Texas

From the Division of Plastic Surgery, Baylor College of Medicine.

Received for publication April 22, 2013; accepted November 11, 2013.

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

Related Video content is available for this article. The videos can be found under the “Related Videos” section of the full-text article, or, for Ovid users, using the URL citations published in the article.

Larry H. Hollier, Jr., M.D., Division of Plastic Surgery, Baylor College of Medicine, 6701 Fannin, Suite CC610.00, Houston, Texas 77030,

©2014American Society of Plastic Surgeons