2023, Number 1
<< Back Next >>
Revista Cubana de Cirugía 2023; 62 (1)
Facial plastic surgery in children with Down syndrome
Burgué CJ, Ung LE
Language: Spanish
References: 29
Page:
PDF size: 443.78 Kb.
ABSTRACT
Introduction:
Down syndrome comprises varying degrees of mental retardation and a number of characteristic facial features. Because these patients present problems in their social, occupational and educational life, solutions have been sought to make these children socially useful individuals. This work shows the results obtained in 22 patients with this syndrome who were surgically treated to correct their facial stigmata.
Objective:
To show the functional changes and aesthetic advantages obtained with facial plastic surgery in patients with Down syndrome.
Methods:
A number of 22 patients with Down syndrome aged 3 to 14 years were chosen, in the period from 1986 to January 2019. The first 15 cases attended in the plastic surgery service of Hospital Pediátrico Docente William Soler were included; later, others attended in other national health centers. The surgical procedures performed for the correction of facial stigmata were partial glossectomy, lateral canthoplasty, medial canthoplasty, and otoplasty.
Results:
Aesthetic and functional changes were favorable, improving appearance and eliminating unattractive features. Positive changes in speech and breathing were obtained. Glossectomy and otoplasty were performed in 100% of cases.
Conclusions:
All operated-on patients attenuated their facial stigmata, while respiratory benefits and speech improvement were reported. The degree of satisfaction of their parents was good.
REFERENCES
Down J. Observations on an ethnic classification of idiots. 1866. Ment Retard. 1995;33(1):54-6.
Lejeune J, Gautier M, Turpin R. Etude des chromosomes somatiques de neuf enfants mongoliens. C R Hebd Seances Acad Sci. 1959;248(11):1721-2.
Jenkins JB, Jenkins JB. (1982). Genética. Reverté.
Lemperle G, Radú D. Facial Plastic Surgery in Children with Down´s Syndrome. Plast. Reconst. Surgery. 1980;66(3):337.
Nussbaum R. (2008). Thompson & Thompson. Genética Médica. Elsevier Brasil.
Roizen N, Patterson D. Down's Syndrome. Lancet.2003 Jan; 361(9365):1281-9.
Taicher S, Sela M. Use of polydimethylsiloxane subdermal implants for correcting facial deformities in Down´s Syndrome. Journal of prosthetic dentistry. 1984;52(2):264-6.
Organización Mundial de la Salud. Genomic resource centre. (2015). Disponible en: http://www.who.int/genomics/en/8.
Hall B. Mongolism in newborn infants. An examination of the criteria for recognition and some speculations on the pathogenic activity of the chromosomal abnormality. Clin Pediatr. 1966;5(1):4-12.
Korbel J, Tirosh-Wagner T, Urban A, Chen X, Kasowski M, Dai L, et al. The genetic architecture of Down syndrome phenotypes revealed by high-resolution analysis of human segmental trisomies. Proc Natl Acad Sci USA. 2009 jul;106(29):12031-6.
Díaz-Cuéllar S, Yokoyama-Rebollar E, Castillo-Ruiz D. Genómica del síndrome de Down. Acta pediátrica de México. 2016;37(5):289-96.
Geelhoed E, Bebbington A, Bower C, Deshpande A, Leonard H. Direct health care costs of children and adolescents with Down syndrome. J Pediatr. 2011 oct;159(4):541-5.
Strauss RP. Social perceptions of the effects of Down´s Syndrome facial surgery: Aschool- based study of ratings by normal adolecents. Plast. Reconst. Surgery. 1988 jun;81(6):841.
Freeman S, Bean L, Allen E, Tinker S, Locke A, Druschel C, et al. Ethnicity, sex, and the incidence of congenital heart defects: a report from the National Down Syndrome Project. Genetics in Medicine. 2008;10 (3):173-80.
Otermin-Aguirre JA. Mongolian and Plastic Surgery. Plast. Reconst. Surgery. 1969;45:411.
Höhler H; Changes in the facial expression as a result of plastic surgery in mongoloid children. Aesthet. Plast. Surgery. 1977;1:245.
Wexler MR, Peled IJ. Rehabilitation of the face in patients with Down´s Syndrome. Plast. Reconst. Surgery. March 1986;77(3):383-90.
Klaiman P, Witzel MA, Margar-Bacal F, Munro IR. Changes in aesthetic appearance and intelligibility of speech after partial glossectomy in patients with Down syndrome. Plast Reconstr Surg. 1988 Sep;82(3):403-8. DOI: https://doi.org/10.1097/00006534-198809000-0000518. . PMID: 2970094.
Parsons CL, Jacono TA. Effect of tongue reduction on articulation in children with Down´s Syndrome. Am. J. Ment. Efic. 1987;91:328.
Giler del Campo YT, Morán Villafuerte JK. (2020). Dislalias orgánicas y su efecto en la articulación en niños con síndrome de Down: estudio a realizarse en la Fundación Dame una Oportunidad en el período 2020 (Doctoral dissertation, Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Tecnología Médica). Disponible en: http://repositorio.ug.edu.ec/handle/redug/5016420.
Cabañas R. Biofisiodinamia de la articulación. Enfoque logofoniátrico. Rev cubana Ped. 1973;45(2):283-6.
Coiffman. Plastic, Reconstructive y Aesthetic Surgery. 4th Ed. Felipe Coiffman. Medellín: Amolca Colombia Editorial; 2016 pág. 628.
Mustardé JC. Cirugía reparadora y reconstructiva de la región orbital. Barcelona. Ediciones Toray. 1982; pp. 353-9.
Patterson S, Munro IR. Transconjunctival lateral canthopexy in Down´s Syndrome patients: A nonstigmatizing approach. Plast. Reconst. Surgery. 1987 may;79(5):714.
Alshafei A, Paran TS. (2020). Macroglossia. Pediatric Surgery: General Principles and Newborn Surgery, 625-30. DOI: https://doi.org/10.1007/978-3-662-43588-5_4325.
Rozner L. Facial plastic surgery for Down's syndrome. Lancet. 1983 Jun 11;1(8337):1320-3. DOI: https://doi.org/10.1016/s0140-6736(83)92426-126. . PMID: 6134105
Pardo SBP, Schneider ARA. Protocolo de atención odontológica en pacientes pediátricos con síndrome de Down. Journal of American Health 2020;35-47. DOI: https://doi.org/10.37958/jah.v3i3.4927.
Cohen JL, Cielo CM, Kupa J, Duffy KA, Hathaway ER, Kalish JM, Taylor JA. The Utility of Early Tongue Reduction Surgery for Macroglossia in Beckwith-Wiedemann Syndrome. Plast Reconstr Surg. 2020 Apr;145(4):803e-813e. DOI: https://doi.org/10.1097/PRS.000000000000667328. . PMID: 32221229; PMCID: PMC8038320.
Glasper E, Powell C. Facial surgery and children with Down's syndrome. Br J Nurs. 1999 Jan 14-27;8(1):6. DOI: https://doi.org/10.12968/bjon.1999.8.1.6. PMID: 10085806.