Surgical treatment of 89 patients with craniofacial microsomia in a craniofacial national reference centre in Finland

This study aims to evaluate surgical treatments for craniofacial microsomia (CFM) at a national reference centre in Finland, focusing on the age of treatment and the number of surgeries performed. The aim was to describe surgical strategies, explore treatment variations, and assess intervention timing. This retrospective cohort study reviewed the medical records of 191 patients diagnosed with CFM at the Helsinki Cleft Palate and Craniofacial Centre from 2010 to 2022. After excluding patients with insufficient data, 89 patients were included. Patients were classified using the Pruzansky-Kaban system, and their surgeries were categorized by type, indication, and age. Of the 89 patients included, 64 patients (72 %) had undergone surgical treatment. Ear reconstruction surgeries were the most common (41 patients or 46 %), followed by soft tissue surgeries in 29 patients (33 %) and cleft-related surgeries in 21 patients (24 %). Hard tissue surgeries, including orthognathic procedures, were performed on nine patients (10 %), primarily those with severe CFM. The median age for surgeries ranged from 0.8 years for cleft surgery to 21.6 years for lipofilling. No significant gender predominance was found. This study highlights the variety of surgical approaches required for treating CFM, with severity influencing the number and type of surgeries. A shift towards conservative treatments for younger patients and a preference for alloplastic implants over autologous grafts were observed. Further research is needed to standardize surgical protocols and treatment outcomes for CFM.