title: Computer-assisted midface reconstruction in Treacher Collins syndrome part 2: soft tissue reconstruction.
abstract: BACKGROUND
  Treacher Collins syndrome (TCS) midfacial involvement associate a skeletal hypoplasia centred on the zygoma to a hypoplasia of all surrounding soft tissues layers and an inferolateral lower lid pseudocoloboma. TCS soft tissue hypoplasia, which has not been well studied, continues to bring challenges in both the indication of surgical treatment and the prediction of their results.
  
  
  METHODS
  From a standard magnetic resonance imaging (MRI) acquisition, we studied qualitatively and quantitatively the prezygomatic fat compartments and the buccal fat pad of two individuals with TCS whose age were 10 and 14 years. In parallel, we studied 20 controls at the same age to obtain a morphometric database of reference and compare our results. TCS soft tissue involvement was correlated to the results of our prior skeletal involvement study.
  
  
  RESULTS
  The midfacial fat compartments in TCS are severely hypoplastic, especially in the superficial and lateral compartments of the face (all P's < 0.001). No significant correlation existed between the soft tissue and the skeletal involvement.
  
  
  CONCLUSIONS
  To our knowledge, this is the first published study of TCS midfacial fat compartments. Their hypoplasia is an important part of the syndrome's facial deformity. The knowledge of their anatomy, organization and volumetric variation is essential. Their re-establishment is key in the early treatment phases of this syndrome. Using the preoperative data, the morphometric database of reference, and surgical simulation, an appropriate surgical technique, going from an autologous fat graft to a free flap, can then be chose.
authors: Department of Plastic and Craniofacial Pediatric Surgery (Head: Pr Guillaume Captier), Faculty of Medicine, University of Montpellier, 371 Avenue du doyen Gaston Giraud, 34295 Montpellier Cedex 5, France. Electronic address: christian.herl@free.fr.
authors: Christian
authors: C
authors: Herlin
authors: Jean Charles
authors: JC
authors: Doucet
authors: Michèle
authors: M
authors: Bigorre
authors: Guillaume
authors: G
authors: Captier
mesh_terms: D000273:Adipose Tissue / Q000002:abnormalities; D000293:Adolescent; D002648:Child; D005145:Face / Q000002:abnormalities / Q000601:surgery*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008342:Mandibulofacial Dysostosis / Q000601:surgery*; D009915:Orbit / Q000473:pathology; D009929:Organ Size; D010347:Patient Care Planning; D019651:Plastic Surgery Procedures / Q000379:methods*; D040521:Subcutaneous Tissue / Q000002:abnormalities; D025321:Surgery, Computer-Assisted / Q000379:methods*; D015050:Zygoma / Q000473:pathology
keywords: Computer-assisted surgery; Fat; Fat grafting; Franceschetti syndrome; Lipofilling; Presurgical simulation; Soft tissue; Treacher Collins syndrome