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Childs Nerv Syst. 2012 Sep;28(9):1571-6. doi: 10.1007/s00381-012-1804-y. Epub 2012 Aug 8.

Complications of frontofacial advancement.

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Craniofacial Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1 3JH, UK.



The purpose of this study was to document the early and late complications associated with frontofacial distraction.


A systematic review of the literature on complications in craniofacial surgery and a review of records of patients undergoing frontofacial distraction at Great Ormond Street Hospital for Children over a 10-year period were conducted.


Complications arising from frontofacial advancement are common. Mortality rates varied between 0 and 4.5 %. There has been a general decline in reported mortality rates with time, and the most recent series report mortalities of less than 1 %. The incidence of significant blood loss (greater than one blood volume) in patients undergoing monobloc osteotomy varied between 5.3 and 9.1 %. CSF leaks following monobloc distraction are common (incidence, 2-20 %). Most of these leaks settle spontaneously. The incidence of frontal bone flap necrosis requiring debridement and a subsequent cranioplasty varied between 3 and 20 %.


The functional and aesthetic benefits of frontofacial distraction are well documented, but these advantages are associated with a significant complication rate. The potential benefits of frontofacial distraction need to be carefully weighed against the potential complications when deciding to recommend surgery.

[Indexed for MEDLINE]

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