title: Radiation-induced craniofacial deformities: a new classification and management algorithm.
abstract: Little is written about the spectrum of late radiation-induced craniofacial abnormalities and the guidelines for treating these abnormalities. The clinical records of 13 patients (eight males and five females) who received childhood craniofacial radiation between birth and 11 years of age and who subsequently had reconstructive surgery were reviewed. Eleven patients had their irradiation at the age from 1 to 5 years. The other two patients received their treatment at a relatively older age (9 and 11 years). Their deformities ranged from isolated soft-tissue deficiency with no or minimal bony deficiency to cases having osseous deformities with or without soft-tissue deficiency but still the normal or near-normal craniofacial form can be obtained with surgical intervention and the outermost extreme of the deformity is the patients whose normal or near-normal craniofacial form and function cannot be regained even with much sophisticated surgeries. Our new classification is based on two factors: the tissue component of the deformity and the possibility of regaining a normal or near-normal craniofacial form and function with the planned surgical intervention. Based on this classification, a new treatment algorithm was created.
authors.affiliation: Cleft-Craniofacial Unit, Plastic Surgery Department, Sohag University, Sohag 82524, Egypt. allamkaram@yahoo.com
authors.forename: Karam A
authors.initials: KA
authors.lastname: Allam
authors.forename: Alan A
authors.initials: AA
authors.lastname: Lim
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elsherbiny
authors.forename: James P
authors.initials: JP
authors.lastname: Bradley
authors.forename: Henry K
authors.initials: HK
authors.lastname: Kawamoto
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000293:Adolescent; D000328:Adult; D000465:Algorithms; D016025:Bone Transplantation; D002648:Child; D002675:Child, Preschool; D005146:Facial Asymmetry / Q000145:classification* / Q000209:etiology / Q000601:surgery; D005147:Facial Bones / Q000528:radiation effects / Q000601:surgery; D005152:Facial Muscles / Q000528:radiation effects / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011832:Radiation Injuries / Q000145:classification* / Q000209:etiology / Q000601:surgery; D011878:Radiotherapy / Q000009:adverse effects; D019651:Plastic Surgery Procedures; D012867:Skin / Q000528:radiation effects; D016038:Skin Transplantation; D012886:Skull / Q000528:radiation effects / Q000601:surgery; D013524:Surgical Flaps; D055815:Young Adult
keywords: Algorithm; Craniofacial deformities; Radiation