Back to 2024 Abstracts
Management Trends and Principles for Pediatric Patients with Poland Syndrome
Dominic Romeo
*, Jacob Ariel, Daniel Martinez-Sallee, Alan Makhoul, Gerardo Perla, Meagan Wu, Jinggang Ng, David Low, Oksana A. Jackson, Cassandra A. Ligh
Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Phiadelphia, Philadelphia, PA
Background:Poland syndrome encompasses a constellation of congenital deformities such as those of the pectoralis muscle, breast, chest, upper limb, ribs, underlying vasculature, and subcutaneous tissue. While early corrective surgery can improve patient quality of life, there is a wide spectrum of treatment approaches with no consensus on ideal operative norms for pediatric patients. This study assesses our institutional experience with a large cohort of pediatric patients with Poland syndrome and analyzes the usefulness of established classification systems in their management.
Methods: A retrospective review of pediatric patients with Poland syndrome seen between 06/2003 and 05/2024 was performed. Patient demographics, Tessier classification, surgical history, and perioperative complications were compared.
Results: A total of 97 pediatric patients with Poland syndrome were included, 50 (51.5%) of whom underwent initial surgery at a median age of 15.5 (13.0-16.5) years. Among those, 12 (24%) had an initial fat graft, 13 (26%) had an initial implant placement, and 19 (38%) had an initial latissimus dorsi flap procedure. A higher proportion of females (62.5%) had surgery than males (36.6%, p<0.05). Those classified as Tessier 1b primarily underwent either fat grafting or implant placement, and none had latissimus dorsi flaps (p<0.001). Most patients who had latissimus flaps (79%) were classified as Tessier 1a (p<0.001). All (19, 100%) latissimus flaps were performed before the age of 18 with 100% flap survival and one (5.3%) requiring a small revision.
Conclusions: Established classification systems can augment surgical decision making in pediatric patients with Poland Syndrome. Patients with less severe deformity are often candidates for less extensive procedures such as fat grafting instead of implant placement or latissimus dorsi flaps. Our group's next step is to analyze our approaches to young women and men and consolidate an institutional treatment algorithm, as we believe all procedures can be done safely in pediatric patients with Poland syndrome.
Back to 2024 Abstracts
