ENDOSCOPIC PEDIATRIC PLASTIC-SURGERY

Although the advent of endoscopic technology is expanding the fields o f reconstructive and aesthetic surgery in adults, there have been to d ate no reports of its use in the pediatric population. Because of its minimally invasive nature, yet wide range of exposure, endoscopic tech niques have much appeal in this age group, Herein we present our initi al experience with endoscopic pediatric plastic surgery. From February 1995 to December 1995, 41 patients were treated utilizing 5-mm and 10 -mm endoscopes at Scottish Rite Children's Medical Center, Atlanta, GA . There were 19 males and 22 females. The mean age at surgery was 5.6 years (range, 7 months-15 years). The most common types of procedures performed were insertion of tissue expanders (N = 19), excision of fac ial dermoids (N = 7), torticollis release (N = 5), and excision of vas cular lesions (N = 4), The remaining 6 patients underwent a variety of reconstructive procedures. The complication rate in the tissue expand er group was 3 out of 39 expanders inserted (9.5%), and consisted of i nfection (N = 2) and rupture (N = 1). In the dermoid group, complicati ons consisted of wound infection requiring reoperation (N = 1), and tr ansient frontal paresis (N = 1). One patient in the hemangioma group h ad an incomplete resection necessitating open excision. The remaining patients all had satisfactory outcomes with no complications. The majo rity of the procedures were done on an outpatient basis. These results suggest that endoscopic techniques are eminently applicable in the pe diatric population, providing the benefits of small and remote incisio nal wounds with complication rates that are comparable to those of con ventional surgical treatment.