Applicability of self-inflating tissue expanders in pediatric patients with head and neck defects

Background: Self-inflating tissue expanders have been used successfully in breast reconstruction, alopecia, scars, and anophthalmos. The expanders contain an osmotic active hydrogel and a silicon shell. The purpose of this study was to analyze our clinical experience using self-inflating tissue expanders in the treatment of alopecia and cleft palate defects in pediatric patients. Methods: Twenty-eight self-inflating tissue expanders were used in 13 patients with alopecia or large cleft palate defects. Expander dimensions were determined by the size of the defect in the scalp and by using a sizer for the palate. In some patients, it was necessary to use more than one expander. A visual analog scale (VAS) and Children’s Hospital of Eastern of Ontario Pain Scale (CHEOPS) were used to determine pain levels. Results: Sufficient tissue was gained in nine patients (69.2%) and 11 of the 16 defects were repaired successfully (68.75 %). We observed four implant extrusions as a major complication (14.2 %). Three of these four extrusions were seen in cleft palate expansions. Pain levels were as low as 5 points with CHEOPS in patients younger than 5 years old and 40 mm with VAS in patients older than 5 years of age. Conclusions: Self-inflating tissue expanders comfortably ensure sufficient tissue in patients with alopecia; however, there is high risk of extrusion in cleft palate applications. Level of Evidence: Level V, therapeutic study.