Prioritizing Cleft/Craniofacial Surgical Care after the COVID-19 Pandemic.


Journal

Plastic and reconstructive surgery. Global open
ISSN: 2169-7574
Titre abrégé: Plast Reconstr Surg Glob Open
Pays: United States
ID NLM: 101622231

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 10 06 2020
accepted: 13 07 2020
entrez: 2 11 2020
pubmed: 3 11 2020
medline: 3 11 2020
Statut: epublish

Résumé

It is anticipated that in due course the burden of emergency care due to COVID-19 infected patients will reduce sufficiently to permit elective surgical procedures to recommence. Prioritizing cleft/craniofacial surgery in the already overloaded medical system will then become an issue. The European Cleft Palate Craniofacial Association, together with the European Cleft and Craniofacial Initiative for Equality in Care, performed a brief survey to capture a current snapshot during a rapidly evolving pandemic. A questionnaire was sent to the 2242 participants who attended 1 of 3 recent international cleft/craniofacial meetings. The respondents indicated that children with Robin sequence who were not responding to nonsurgical options should be treated as emergency cases. Over 70% of the respondents indicated that palate repair should be performed before the age of 15 months, an additional 22% stating the same be performed by 18 months. Placement of middle ear tubes, primary cleft lip surgery, alveolar bone grafting, and velopharyngeal insufficiency surgery also need prioritization. Children with craniofacial conditions such as craniosynostosis and increased intracranial pressure need immediate care, whilst children with craniosynostosis and associated obstructive sleep apnea syndrome or proptosis need surgical care within 3 months of the typical timing. Craniosynostosis without signs of increased intracranial pressure needs correction before the age of 18 months. This survey indicates several areas of cleft and craniofacial conditions that need prioritization, but also certain areas where intervention is less urgent. We acknowledge that there will be differences in the post COVID-19 response according to circumstances and policies in individual countries.

Sections du résumé

BACKGROUND BACKGROUND
It is anticipated that in due course the burden of emergency care due to COVID-19 infected patients will reduce sufficiently to permit elective surgical procedures to recommence. Prioritizing cleft/craniofacial surgery in the already overloaded medical system will then become an issue. The European Cleft Palate Craniofacial Association, together with the European Cleft and Craniofacial Initiative for Equality in Care, performed a brief survey to capture a current snapshot during a rapidly evolving pandemic.
METHODS METHODS
A questionnaire was sent to the 2242 participants who attended 1 of 3 recent international cleft/craniofacial meetings.
RESULTS RESULTS
The respondents indicated that children with Robin sequence who were not responding to nonsurgical options should be treated as emergency cases. Over 70% of the respondents indicated that palate repair should be performed before the age of 15 months, an additional 22% stating the same be performed by 18 months. Placement of middle ear tubes, primary cleft lip surgery, alveolar bone grafting, and velopharyngeal insufficiency surgery also need prioritization. Children with craniofacial conditions such as craniosynostosis and increased intracranial pressure need immediate care, whilst children with craniosynostosis and associated obstructive sleep apnea syndrome or proptosis need surgical care within 3 months of the typical timing. Craniosynostosis without signs of increased intracranial pressure needs correction before the age of 18 months.
CONCLUSIONS CONCLUSIONS
This survey indicates several areas of cleft and craniofacial conditions that need prioritization, but also certain areas where intervention is less urgent. We acknowledge that there will be differences in the post COVID-19 response according to circumstances and policies in individual countries.

Identifiants

pubmed: 33133937
doi: 10.1097/GOX.0000000000003080
pmc: PMC7544383
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e3080

Informations de copyright

Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.

Déclaration de conflit d'intérêts

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Références

J Craniofac Surg. 2020 Sep;31(6):e618-e620
pubmed: 32404622
Plast Reconstr Surg Glob Open. 2020 Jun 24;8(7):e3039
pubmed: 32802692

Auteurs

Corstiaan Breugem (C)

Department of Plastic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands.

Hans Smit (H)

Department of Plastic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands.

Hans Mark (H)

Department of Plastic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.

Gareth Davies (G)

European Cleft and Craniofacial Initiative for Equality in Care, European Cleft Organisation, The Netherlands.

Peter Schachner (P)

Department of Maxillofacial Surgery, Universitätsklinik Uniklinikum, Salzburg, Austria.

Mechelle Collard (M)

Swansea Bay University Health Board, United Kingdom.

Debbie Sell (D)

Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom.

Luca Autelitano (L)

Smile House, Department of Maxillo-Facial Surgery, Ospedale San Paolo e Carlo, Milano, Italy.

Angela Rezzonico (A)

Smile House, Department of Maxillo-Facial Surgery, Ospedale San Paolo e Carlo, Milano, Italy.

Fabio Mazzoleni (F)

Department of Maxillo-Facial Surgery, Ospedale San Gerardo, Monza, Italy.

Giorgio Novelli (G)

Department of Maxillo-Facial Surgery, Ospedale San Gerardo, Monza, Italy.

Peter Mossey (P)

Department of Orthodontics, University of Dundee, Dundee, United Kingdom.

Martin Persson (M)

Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden, European Cleft and Craniofacial Initiative for Equality in Care.

Felicity Mehendale (F)

Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom.

Alexander Gaggl (A)

Department of Maxillofacial Surgery, Universitätsklinik Uniklinikum, Salzburg, Austria.

Christine van Gogh (C)

Department of ENT Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands.

Petra Zuurbier (P)

Department of Orthodontics, Amsterdam University Medical Center, Amsterdam, The Netherlands.

Siegmar Reinart (S)

Department of Maxillofacial Surgery, Universitätsklinikum Tuebingen, Tuebingen, Germany.

Feike de Graaff (F)

Department of Plastic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands.

Costanza Meazzini (C)

Smile House, Department of Maxillo-Facial Surgery, Ospedale San Paolo e Carlo, Milano, Italy.
Department of Maxillo-Facial Surgery, Ospedale San Gerardo, Monza, Italy.

Classifications MeSH