Evaluation of cephalometric points in midface bone lengthening with the use of a rigid external device in syndromic craniosynostosis patients

Abstract

da Bahia. In charge of the craniomaxillofacial surgery sector. 2 Livre-docente (habilitation) professor, USP Medical School. In charge of the craniomaxillofacial surgery sector, Plastic Surgery and Burns Division, Hospital das Clínicas da FMUSP. 3 Master's degree in orthodontics. Orthodontist of the craniomaxillofacial surgery sector, Plastic Surgery and Burns Division, Hospital das Clínicas da FMUSP.

Assessment of Orbital Volume in Frontofacial Advancements

“…12,14 The number of publications regarding measurements of orbit volume to evaluate surgical treatment of exorbitism in patients with syndromic CS is scarce. 4,6,[17][18][19] In this study, when the volumetric measurements between groups were compared, a greater orbit volume (preoperatively and postoperatively) was observed in group LF for the left and right orbits.…”

“…The use of this surgical technique has been widespread in large centers and is currently considered the treatment of choice for patients with syndromic CS. 2,3,[9][10][11][12][13][14] The objectives of the present study were to evaluate patients with syndromic craniofaciosynostosis submitted to craniofacial osteotomies (Le Fort III and monobloc) using distractor devices, to the following parameters: (a) increase and variation of orbital volumes, (b) magnitude of craniofacial advances and its vectors, (c) correlation between the variation of the orbital volumes and craniofacial advances, and (d) effectiveness of craniofacial advances through comparisons between normal levels of orbital volumes.…”

Retrospective study on midfacial advancement in syndromic craniosynostosis: case series

“…The craniodentofacial features include brachycephaly, hypertelorism, exophthalmos, proptosis, midfacial hypoplasia, skeletal Class III, Angle Class III malocclusion, maxillary atresia, open bite, and severe dental crowding . The diagnosis is made via clinical and complementary examinations, such as panoramic and cephalometric radiographs, computed tomography, and cephalometric analysis …”

“…The gold standard surgical treatments include: cranial expansion to release the synostotic sutures during the first year of life, Le Fort III or monobloc frontofacial osteotomy to midfacial advancement during childhood, which is followed by distraction osteogenesis (DO) …”

Avaliação por imagem tridimensional das características morfológicas e do crescimento do terço médio da face de pacientes com craniossinostose sindrômica submetidos ao avanço frontofacial em monobloco associado à distração osteogênica

“…A fusão completa ou parcial das suturas e sincondroses craniofaciais impedem o deslocamento normal entre os ossos envolvidos 53 A maioria, no entanto, dos estudos, demonstra pouco ou inexistente crescimento sagital da maxila após a cirurgia de avanço facial, seja LFIII ou monobloco. No que se refere à estabilidade, as evidências atuais apontam que a combinação da DO às osteotomias de terço médio reduz enormemente as taxas de recidiva comparadas aos procedimentos convencionais 6,12,14,[60][61][62][63][64][65] . A neoformação óssea associada à expansão gradual e simultânea de partes moles confere estabilidade suficiente para evitar recidiva 64,66,67 .…”