Operative correction and follow-up of craniofacial duplication.
BACKGROUND
Anterior craniofacial duplication (diprosopus) is an extremely rare form of conjoined twins. The children share a single trunk with normal extremities and varying degrees of facial malformation. Duplication of specific structures, such as the nose (diprosopus dirrhinus), eyes (diprosopus tetraophthalmus), and ears, is possible. The authors present a case of partial facial duplication (diprosopus dirrhinus) in a male infant.


METHODS
The clinical and radiographic findings and the surgical correction and follow-up are described.


RESULTS
In a single surgical session, the authors were able to achieve not only a functionally but also an aesthetically acceptable result. In the postoperative course, the child showed nearly normal growth and satisfactory psychosocial and motor development. However, 40 months postoperatively, we noticed a tendency of the orbitae to diverge (i.e., toward hypertelorism).


CONCLUSIONS
The surgical management of complex craniofacial malformations such as diprosopus needs a precise morphologic analysis of the patient's deformity followed by a clear treatment plan. A staged reconstructive approach is carried out to coincide with facial growth patterns and brain and eye function. If the interorbital distance in our patient increases progressively, a second operation for reduction of the interorbital distance may be necessary.
Kotrikova
Bibiana
B
Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany. bibiana.kotrikova@online.de
Hassfeld
Stefan
S
Steiner
Hans H
HH
Hähnel
Stefan
S
Krempien
Robert
R
Mühling
Joachim
J
D019465:Craniofacial Abnormalities / Q000601:surgery*; D005147:Facial Bones / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D009666:Nose / Q000002:abnormalities / Q000601:surgery; D010027:Osteotomy; D019651:Plastic Surgery Procedures / Q000379:methods*