title: Parry-Romberg syndrome: severity of the deformity does not correlate with quality of life.
abstract: BACKGROUND
  The aims of this study were to (1) describe the main clinical findings of Parry-Romberg syndrome (PRS), (2) evaluate surgical strategies and outcomes, and (3) investigate the quality of life of patients according to their disease severity.
  
  
  METHODS
  This retrospective observational study involved 14 patients treated between 2005 and 2011. The surgical treatment strategies were based on the proposed system for grading severity, and postoperative outcomes were assessed. The patients answered two questionnaires that covered the clinical manifestations of the syndrome and their quality of life in the postoperative period. A comparative analysis between the severity of the deformity and the quality of life was performed using the Kruskal-Wallis and Mann-Whitney tests.
  
  
  RESULTS
  The most prevalent clinical manifestation of PRS was progressive hemifacial atrophy (85.71 %). The surgical strategy was individualized based on the severity of disease of each patient. Surgical strategies included free-fat grafts, dermal fat grafts, and bone grafts associated with a temporoparietal fascia flap. Regardless of approach, all patients had an overall improvement in their facial appearance and were free of complications during the follow-up period. Our data showed no association between the severity of the deformity and the quality of life of these patients (all p > 0.05).
  
  
  CONCLUSIONS
  In this series, there was a predominance of clinical features of PRS that had been previously reported. Satisfactory outcomes were obtained using different surgical strategies that varied according to the severity of the deformity. The severity of the deformity did not impose a reduced quality of life on PRS patients.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Av. Adolpho Lutz, 100, Cidade Universitária, Caixa Postal 6028, Campinas, São Paulo, Brazil. sobrapar@sobrapar.org.br
authors.forename: Cassio Eduardo
authors.initials: CE
authors.lastname: Raposo-Amaral
authors.forename: Rafael
authors.initials: R
authors.lastname: Denadai
authors.forename: Daniella Nunes
authors.initials: DN
authors.lastname: Camargo
authors.forename: Thiago Olivetti
authors.initials: TO
authors.lastname: Artioli
authors.forename: Yara
authors.initials: Y
authors.lastname: Gelmini
authors.forename: Celso Luiz
authors.initials: CL
authors.lastname: Buzzo
authors.forename: Cesar Augusto
authors.initials: CA
authors.lastname: Raposo-Amaral
mesh_terms: D050153:Abdominal Fat / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D002648:Child; D005150:Facial Hemiatrophy / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult