{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T07:02:34Z","timestamp":1780038154939,"version":"3.53.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Le Fort III osteotomy and advancement in children with Crouzon syndrome represents a crucial therapeutic modality for severe midface hypoplasia. These procedures are highly invasive and associated with significant intraoperative hemorrhage and difficult airway management, posing substantial anesthetic risks. This study aims to summarize perioperative anesthetic management strategies, describe perioperative outcomes, and analyze risk factors for postoperative complications in this specific population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical records of consecutive children with Crouzon syndrome undergoing Le Fort III osteotomy and advancement were retrospectively reviewed from Peking University International Hospital between December 2017 and January 2026. Inclusion criteria were: (i) diagnosis of Crouzon syndrome; (ii) underwent Le Fort III osteotomy and advancement; and (iii) age younger than 18 years at the time of surgery. Data extracted included demographics, perioperative management, complications, fluid and transfusion volumes, and length of stay. Risk factors for postoperative complications were analyzed using univariate and multivariate logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 47 children (male, 24) were enrolled, with a median age of 6 years (IQR, 6\u201310 years). The median operative time was 215\u2005minutes (IQR, 180\u2013279\u2005minutes), intraoperative blood loss was 14.3\u2005mL\/kg, and the allogeneic blood transfusion rate was 68.1%. Postoperative complications occurred in 29.8% of patients (14\/47). Multivariate logistic regression analysis identified operative duration (odds ratio [OR]\u2009=\u20091.010; 95% confidence interval [CI], 1.001\u20131.021;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.048) as an independent risk factor for postoperative complications. Intraoperative fresh frozen plasma transfusion were not significant in the adjusted model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Anesthetic management for Le Fort III osteotomy in children with Crouzon syndrome requires meticulous attention to difficult airway anatomy and significant intraoperative hemorrhage. Prolonged operative duration significantly increase the risk of postoperative complications. Future research should prioritize multicenter prospective cohort designs to establish larger, more comprehensive databases capable of validating the present findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1840355","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T06:11:22Z","timestamp":1780035082000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative anesthetic considerations and outcomes in Crouzon syndrome: a retrospective analysis of Le Fort III advancement surgery"],"prefix":"10.3389","volume":"14","author":[{"given":"Yue","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunpeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Peking University International Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"214","DOI":"10.3340\/jkns.2016.59.3.214","article-title":"Update of diagnostic evaluation of craniosynostosis with a focus on pediatric systematic evaluation and genetic studies","volume":"59","author":"Hwang","year":"2016","journal-title":"J Korean Neurosurg Soc"},{"key":"B2","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1111\/j.1399-0004.1992.tb03620.x","article-title":"Birth prevalence studies of the Crouzon syndrome: comparison of direct and indirect methods","volume":"41","author":"Cohen","year":"1992","journal-title":"Clin Genet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"21","DOI":"10.3171\/2009.3.PEDS08355","article-title":"Evolution in the frequency of nonsyndromic craniosynostosis","volume":"4","author":"Di Rocco","year":"2009","journal-title":"J Neurosurg Pediatr"},{"key":"B4","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.jcms.2021.11.008","article-title":"Algorithm to the treatment of Crouzon syndrome","volume":"50","author":"Raffaini","year":"2022","journal-title":"J Craniomaxillofac Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1111\/j.1460-9592.2012.03927.x","article-title":"Anesthesia for surgery related to craniosynostosis: a review. 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