Late presenting bilateral squamosal synostosis

Premature fusion of one or other of the minor sutures can subtly influence the shape of the humanskull. Although infrequently reported or not clinically recognized, it can such contribute to a varietyof craniofacial dysmorphisms. We herein report a case of late presenting, isolated bilateral synostosisof the squamosal suture dysmorphologies whose presentation mimics aspects of sagittalsynostosis.

Incidental finding of co-existing life-threatening pathology during facial trauma assessment

Paediatric facial traumas are often accompanied by other intracranial and non-head injuries. Use of Computed Tomography (CT) has increased diagnostic accuracy when compared to plain radiographs alone. Coexisting anomalies can sometimes be a chance finding from the imagings and this highlights the need of a formal reporting by a radiologist. We report a case of a traumatic unilateral condylar fracture with a coexisting life-threatening abnormality detected from careful assessment of the imagings.

Longitudinal outcome of pharyngoplasty

Although early complication of airway obstruction following pharyngoplasty is well recognised, there have been few reports of late modifications following this procedure. We retrospectively review cases with late complications which have required either revision or division of an existing pharyngoplasty at the Australian Craniofacial Unit over the last twenty-five years. We assess the outcome of further surgical intervention in each case, with case note and nasendoscopy video review. Fourteen cases were identified where records were complete. There were 12 males and 2 females. The cases are a heterogeneous group of cleft lip and palate patients and include three cases with a diagnosis of Pierre-Robin sequence and one case with a cleft palate as part of an underlying syndrome. Those cases requiring flap division had undergone either superiorly or inferiorly based pharyngeal flaps in contrast to dynamic (Orticochea) pharyngoplasties which required revision. This series of cases demonstrates the need for thorough assessment and planned tailoring of the pharyngoplasty procedure, with ongoing review of speech and airway function. This management philosophy results in the acceptance that a pharyngoplasty may only be required for a limited period of time and ultimately may be redundant.