Evaluation of Cephalometric Points in Midface Bone Lengthening with the Use of a Rigid External Device in Syndromic Craniosynostosis Patients

Overview

Journal Braz J Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2009 Aug 4

PMID 19649491

Citations 3

Authors

Daniel Santos Correa Lima

Nivaldo Alonso

Paulo Roberto Pelucio Camara

Dov Charles Goldenberg

Affiliations

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Abstract

Unlabelled: Distraction osteogenesis has been extensively used to correct severe midface hypoplasia in syndromic craniosynostosis patients. However few studies have reported midface distraction outcomes through cephalometric evaluation.

Aim: The purpose of the present study was to evaluate outcomes with midface distraction rigid external device (RED) in patients with syndromic craniosynostosis, in terms of quantity of bone lengthening, skeletal stability and facial growth.

Materials And Methods: Eleven patients were retrospectively evaluated in this study. Cephalometrics was carried out through three teleradiographies from each patient (T1 -before surgery; T2- immediate postop, rigth after distractor removal; T3 - late postop, obtained with a minimal interval of 12 months after surgery).

Results: Significant midface advancement was achieved with the procedure. The rate of horizontal relapse was minimal. We noticed a clear vertical facial growth, contrary to what was seen in the horizontal aspect, when there was a mild posterior relapse and no growth evidence.

Conclusion: Cephalometric evaluation showed adequate results in midface bone lengthening with rigid external distractor.

Citing Articles

Midface Morphology and Growth in Syndromic Craniosynostosis Patients Following Frontofacial Monobloc Distraction.

Tonello C, Cevidanes L, Ruellas A, Alonso N J Craniofac Surg. 2020; 32(1):87-91.

PMID: 33136785 PMC: 8011493. DOI: 10.1097/SCS.0000000000006997.

Comparison of Midface Advancement by External and Internal Craniofacial Distraction Osteogenesis.

Balaji S, Balaji P Ann Maxillofac Surg. 2019; 8(2):200-205.

PMID: 30693232 PMC: 6327809. DOI: 10.4103/ams.ams_234_18.

Guideline for Care of Patients With the Diagnoses of Craniosynostosis: Working Group on Craniosynostosis.

Mathijssen I J Craniofac Surg. 2015; 26(6):1735-807.

PMID: 26355968 PMC: 4568904. DOI: 10.1097/SCS.0000000000002016.

References

Bachmayer D, Ross R, Munro I . Maxillary growth following LeFort III advancement surgery in Crouzon, Apert, and Pfeiffer syndromes. Am J Orthod Dentofacial Orthop. 1986; 90(5):420-30. DOI: 10.1016/0889-5406(86)90007-7. View

Fearon J . The Le Fort III osteotomy: to distract or not to distract?. Plast Reconstr Surg. 2001; 107(5):1091-103; discussion 1104-6. DOI: 10.1097/00006534-200104150-00001. View

Shetye P, Boutros S, Grayson B, McCarthy J . Midterm follow-up of midface distraction for syndromic craniosynostosis: a clinical and cephalometric study. Plast Reconstr Surg. 2007; 120(6):1621-1632. DOI: 10.1097/01.prs.0000267422.37907.6f. View

Shapiro P, Kokich V, Hohl T, Loe C . The effects of early Le Fort I osteotomies on craniofacial growth of juvenile Macaca nemestrina monkeys. Am J Orthod. 1981; 79(5):492-9. DOI: 10.1016/s0002-9416(81)90461-9. View

Kaban L, West B, Conover M, Will L, Mulliken J, Murray J . Midface position after LeFort III advancement. Plast Reconstr Surg. 1984; 73(5):758-67. DOI: 10.1097/00006534-198405000-00007. View

Nishimoto S, Oyama T, Shimizu F, Tsugawa T, Nagashima T, Yamamoto K . Fronto-facial monobloc advancement with rigid external distraction (RED-II) system. J Craniofac Surg. 2004; 15(1):54-9. DOI: 10.1097/00001665-200401000-00017. View

Squier C, Kremenak C . Quantitation of the healing palatal mucoperiosteal wound in the beagle dog. Br J Exp Pathol. 1982; 63(5):573-84. PMC: 2040759. View

Firmin F, COCCARO P, CONVERSE J . Cephalometric analysis in diagnosis and treatment planning of craniofacial dysostoses. Plast Reconstr Surg. 1974; 54(3):300-11. DOI: 10.1097/00006534-197409000-00007. View

McCarthy J, Glasberg S, Cutting C, Epstein F, Grayson B, Ruff G . Twenty-year experience with early surgery for craniosynostosis: II. The craniofacial synostosis syndromes and pansynostosis--results and unsolved problems. Plast Reconstr Surg. 1995; 96(2):284-95; discussion 296-8. View

10.

ROSEN H, Whitaker L . Cranial base dynamics in craniofacial dysostosis. J Maxillofac Surg. 1984; 12(2):56-61. DOI: 10.1016/s0301-0503(84)80212-x. View

11.

Tuncbilek G, Mavili M, Vargel I, Enacar A, Erk Y . Midface distraction using spring scale attached to rigid external device. Plast Reconstr Surg. 2004; 113(5):1410-6. DOI: 10.1097/01.prs.0000112749.21267.0a. View

12.

Gillies H, Harrison S . Operative correction by osteotomy of recessed malar maxillary compound in a case of oxycephaly. Br J Plast Surg. 1950; 3(2):123-7. DOI: 10.1016/s0007-1226(50)80019-x. View

13.

Holmes A, Wright G, Meara J, Heggie A, Probert T . LeFort III internal distraction in syndromic craniosynostosis. J Craniofac Surg. 2002; 13(2):262-72. DOI: 10.1097/00001665-200203000-00014. View

14.

Tessier P . The definitive plastic surgical treatment of the severe facial deformities of craniofacial dysostosis. Crouzon's and Apert's diseases. Plast Reconstr Surg. 1971; 48(5):419-42. DOI: 10.1097/00006534-197111000-00002. View

15.

Shin J, Duncan C, Persing J . Monobloc distraction: technical modification and considerations. J Craniofac Surg. 2003; 14(5):763-6. DOI: 10.1097/00001665-200309000-00030. View

16.

Meazzini M, Mazzoleni F, Caronni E, Bozzetti A . Le Fort III advancement osteotomy in the growing child affected by Crouzon's and Apert's syndromes: presurgical and postsurgical growth. J Craniofac Surg. 2005; 16(3):369-77. DOI: 10.1097/01.scs.0000157201.81438.31. View

17.

Kubler A, Speder B, Zoller J . Fronto-orbital advancement with simultaneous LeFort III-distraction. J Craniomaxillofac Surg. 2004; 32(5):291-5. DOI: 10.1016/j.jcms.2004.04.009. View

18.

David D, Sheen R . Surgical correction of Crouzon syndrome. Plast Reconstr Surg. 1990; 85(3):344-54. DOI: 10.1097/00006534-199003000-00002. View

19.

Tessier P . Total osteotomy of the middle third of the face for faciostenosis or for sequelae of Le Fort 3 fractures. Plast Reconstr Surg. 1971; 48(6):533-41. DOI: 10.1097/00006534-197112000-00003. View

20.

McCarthy J, Grayson B, Bookstein F, Vickery C, Zide B . Le Fort III advancement osteotomy in the growing child. Plast Reconstr Surg. 1984; 74(3):343-54. DOI: 10.1097/00006534-198409000-00003. View