Featured Research

from universities, journals, and other organizations

Face transplantation calls for 'reverse craniofacial planning'

Date:
December 10, 2012
Source:
Wolters Kluwer Health: Lippincott Williams & Wilkins
Summary:
As surgical teams gain experience with facial transplantation, a careful approach to planning based on the principles of craniofacial surgery can help to maximize patient outcomes in terms of facial form and function.

As surgical teams gain experience with facial transplantation, a careful approach to planning based on the principles of craniofacial surgery can help to maximize patient outcomes in terms of facial form and function, according to an article in The Journal of Craniofacial Surgery.

In patients with extensive facial defects including loss of the normal bone and soft tissue landmarks, a "reverse craniofacial planning" approach can restore normal facial relationships, the report suggests. The lead author was Dr. Edward J. Caterson, a member of the facial transplant team at Brigham and Women's Hospital/Harvard Medical School, Boston.

Craniofacial Principles Applied to Facial Transplantation

Dr. Caterson and colleagues apply some basic principles of craniofacial surgery to the planning and performance of facial transplants. Although still a rare and relatively new procedure, facial transplantation now offers a reconstructive option for patients with severe facial deficits. Most patients who are candidates for facial transplant have loss of soft tissues only (such as skin, muscle, blood vessels, and nerves).

However, some patients also have defects of the underlying facial bones. In these cases, the challenge for the facial transplant team is nothing less than "the complete restoration of the structural anatomy of the craniofacial skeleton," the authors write.

Through their experience with reconstructive surgery in patients with severe congenital deformities, craniofacial surgeons have developed an understanding of the "intimate functional relationship" between the facial soft tissue and supporting bone. In the traditional craniofacial procedure, the surgeon carefully plans and designs "bone movements that will translate into a desired change of the attached soft tissues."

But in facial transplantation, the situation is essentially reversed: the degree of injury and the subsequent transplantation of facial soft tissues dictate the "osteosynthesis" of the craniofacial skeleton. Dr. Caterson and colleagues describe a simple but practical technique for surgical planning to promote proper positioning of the facial transplant. The technique applies "normative" data on facial landmarks and relationships and then transposes them onto the recipient.

Understanding the relationships of facial structure allows surgeons to compensate for missing bony or soft tissue landmarks. The authors provide a straightforward approach to establishing a plane of reference, allowing the facial transplant to be positioned in a proper relationship with the skull base and occlusal plane (teeth and lower face).

Optimal positioning of the facial transplant is essential not only to achieve the most normal-appearing result, but also to maximize function -- particularly in eating and breathing. Dr. Caterson and colleagues emphasize that "proper positioning of the hard tissues of the allograft is the fundamental starting point for functional and aesthetic restoration." As long as the bony structure is right, any cosmetic soft tissue problems that remain after surgery are relatively easy to correct.

The authors believe that such craniofacial principles are likely to become an increasingly important consideration -- "especially with the trend toward full face transplantation." In early experience, donor selection for face transplantation has focused mainly on immunological factors -- similar to those used in organ transplantation.

In the future, transplant teams may become more sophisticated in donor selection -- including assessment of the degree of "craniofacial match" between donors and recipients. In the meantime, Dr. Caterson and coauthors conclude, "[C]areful attention to the soft tissue relationships with the skeletal anatomy requires that face transplantation include 'reverse craniofacial planning' to optimize the form and function of the recipient's new face."


Story Source:

The above story is based on materials provided by Wolters Kluwer Health: Lippincott Williams & Wilkins. Note: Materials may be edited for content and length.


Journal Reference:

  1. Edward J. Caterson, J. Rodrigo Diaz-Siso, Pradip Shetye, Johan P. E. Junker, Ericka M. Bueno, Shigeyoshi Soga, Frank J. Rybicki, Bohdan Pomahac. Craniofacial Principles in Face Transplantation. Journal of Craniofacial Surgery, 2012; 23 (5): 1234 DOI: 10.1097/SCS.0b013e318252d406

Cite This Page:

Wolters Kluwer Health: Lippincott Williams & Wilkins. "Face transplantation calls for 'reverse craniofacial planning'." ScienceDaily. ScienceDaily, 10 December 2012. <www.sciencedaily.com/releases/2012/12/121210101340.htm>.
Wolters Kluwer Health: Lippincott Williams & Wilkins. (2012, December 10). Face transplantation calls for 'reverse craniofacial planning'. ScienceDaily. Retrieved October 23, 2014 from www.sciencedaily.com/releases/2012/12/121210101340.htm
Wolters Kluwer Health: Lippincott Williams & Wilkins. "Face transplantation calls for 'reverse craniofacial planning'." ScienceDaily. www.sciencedaily.com/releases/2012/12/121210101340.htm (accessed October 23, 2014).

Share This



More Health & Medicine News

Thursday, October 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Fears Keep Guinea Hospitals Empty

Ebola Fears Keep Guinea Hospitals Empty

AP (Oct. 23, 2014) Fears of Ebola are keeping doctors and patients alike away from hospitals in the West African nation of Guinea. (Oct. 23) Video provided by AP
Powered by NewsLook.com
Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Orthodontist Mom Jennifer Salzer on the Best Time for Braces

Working Mother (Oct. 22, 2014) Is your child ready? Video provided by Working Mother
Powered by NewsLook.com
U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

Newsy (Oct. 22, 2014) Now that the U.S. is restricting travel from West Africa, some are dropping questions about a travel ban and instead asking about visa bans. Video provided by Newsy
Powered by NewsLook.com
More People Diagnosed With TB In 2013, But There's Good News

More People Diagnosed With TB In 2013, But There's Good News

Newsy (Oct. 22, 2014) The World Health Organizations says TB numbers rose in 2013, but it's partly due to better detection and more survivors. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins