Workflow for Pediatric Midface and Orbital Reconstruction With a Patient-Specific Autogenous Bone Graft

Extensive midface and orbital reconstruction is challenging, especially in a pediatric population. A 13-year-old patient was diagnosed with fibrous dysplasia of the midface, which required complete resection of the zygomatic bone and orbital floor. The authors present a complete midface and orbital reconstruction, using a patient-specific autologous bone graft, in a growing pediatric patient. Postoperative analysis showed a symmetric orbital floor and good clinical outcome. After 12 months of follow up, no bone resorption was observed. Patient-specific autologous bone grafts have a clear role in the treatment algorithm of patients with large skull bone defects, with emphasis on the pediatric patient. The advantages can be even greater in a pediatric population, because they can benefit more from the minimal invasive approach. Furthermore, this technique allows single-stage complex reconstructive surgeries with a decreased operating time. Accepted for publication July 8, 2018. The authors have no financial or personal relationship with organizations that could inappropriately influence or bias this work. The authors have no conflict of interest to declare from the following organizations: National Institutes of Health (NIH), Welcome Trust, Howard Hughes Medical Institute (HHMI), Research Council UK, and other(s). Address correspondence and reprint requests to Yasmin Opdenakker, M.D., Department of Maxillo-Facial Surgery, University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. E-mail: yasmin.opdenakker@gmail.com © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.