Reconstruction of late craniofacial deformities after irradiation of the head and face during childhood

Journal Article · Wed Aug 01 04:00:00 EDT 1990 · Plastic and Reconstructive Surgery; (USA)

DOI:https://doi.org/10.1097/00006534-199008000-00004· OSTI ID:6869646

Cohen, S R; Bartlett, S P; Whitaker, L A ^[1]

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1. Children's Hospital of Philadelphia, PA (USA)

Little is known about the results of surgical management of late craniofacial abnormalities arising after irradiation of the head and face for treatment of childhood cancers. The clinical records of 10 children (4 males and 6 females) who received 4500 to 6500 rads (mean 5160 rads) of craniofacial radiation between birth and 8 years of age (mean 5 years) and who subsequently had reconstructive surgery were reviewed. Six of the 10 patients received orbital radiation, 3 received maxillary-midfacial radiation, and 1 patient underwent radiation to the frontal bone. Histologic tumor types included retinoblastoma (4), rhabdomyosarcoma (3), Ewing's sarcoma (2), and neurofibrosarcoma (1). In addition to radiation, 7 of the 10 patients underwent surgical resection or debulking of their tumors and 6 received adjuvant chemotherapy. All patients presented from 4 to 20 years after treatment (mean 10 years) with varying, but severe degrees of soft-tissue and bony hypoplasia of the irradiated territories. Onlay bone grafting with soft-tissue reconstruction by a combination of local pedicle flaps and dermal-fat grafts was initially performed in 9 patients, and an occipitoparietal bone-flap switch procedure was done in 1 patient. Late follow-up ranged from 11 months to 7.5 years (mean 34 months). A total of 8 secondary procedures were necessary in 4 of the 10 patients (40 percent). Of these 4 patients, major revisions were performed in 3 and minor adjustments in 1. In addition, 2 patients in whom secondary procedures had not been done would benefit from further reconstruction. Therapy for cancer of the head and face during childhood has profound and ongoing effects on the growth of soft tissue and bone.

• OSTI ID: 6869646
• Journal Information: Plastic and Reconstructive Surgery; (USA), Journal Name: Plastic and Reconstructive Surgery; (USA) Vol. 86:2; ISSN PRSUA; ISSN 0032-1052
• Country of Publication: United States
• Language: English

Related Subjects

560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
AGE GROUPS
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BODY AREAS
CHILDREN
DELAYED RADIATION EFFECTS
DISEASES
GRAFTS
HEAD
INJURIES
MEDICINE
NECK
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
PLASTIC SURGERY
RADIATION EFFECTS
RADIATION INJURIES
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SKELETON
SKULL
SURGERY
THERAPY
TRANSPLANTS