title: Paediatric transcranial surgery: a review of 114 consecutive procedures.
abstract: Craniofacial units have a responsibility to collect data, to promote research and training and to carry out audit. We present a review of 114 consecutive transcranial procedures performed in 110 children in our unit over an 8 year period, with particular reference to complications. There were no deaths in this series. Complications included two cases of excessive intraoperative blood loss necessitating a delay in the procedure, and two postoperative infections that required aggressive antibiotic management. Minor complications, delaying hospital discharge, occurred in 13 patients. Within the range of paediatric transcranial procedures performed, the potential for complications is greater for complex osteotomies in syndromic conditions than for single sutural synostosis correction. The transcranial case mix included a relatively small number of craniofacial dysostoses, which contributes to the very low complication rate reported. This report demonstrates that multidisciplinary assessment and planning, adherence to craniofacial surgical principles, shorter operating times and avoidance of high-risk procedures contribute to a low complication rate, and confirms that paediatric transcranial procedures can be safely performed in dedicated centres where there is a multidisciplinary team with appropriate commitment and experience.
authors.affiliation: Department of Craniofacial Surgery, Chelsea and Westminster Hospital, London, UK.
authors.forename: W N A
authors.initials: WN
authors.lastname: Kirkpatrick
authors.forename: C E
authors.initials: CE
authors.lastname: Koshy
authors.forename: N
authors.initials: N
authors.lastname: Waterhouse
authors.forename: N J
authors.initials: NJ
authors.lastname: Fauvel
authors.forename: R J
authors.initials: RJ
authors.lastname: Carr
authors.forename: D C
authors.initials: DC
authors.lastname: Peterson
mesh_terms: D000293:Adolescent; D000758:Anesthesia / Q000379:methods; D001424:Bacterial Infections / Q000209:etiology; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000209:etiology; D003229:Conjunctival Diseases / Q000209:etiology; D003238:Connective Tissue / Q000473:pathology; D019465:Craniofacial Abnormalities / Q000601:surgery*; D003394:Craniofacial Dysostosis / Q000601:surgery; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D009336:Necrosis; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012307:Risk Factors; D012640:Seizures / Q000209:etiology; D013580:Synostosis / Q000601:surgery