Current practice of distraction osteogenesis for craniofacial anomalies in Europe: A web based survey

Nada, Rania M.; Sugar, Adrian; Wijdeveld, Maarten G.M.M.; Borstlap, W.A.; Clauser, Luigi; Hoffmeister, Bodo; Kuijpers-Jagtman, Anne Marie

doi:10.1016/j.jcms.2009.03.014

Cited by 47 publications

(18 citation statements)

References 20 publications

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“…Other limitations were that treatments for SRDB could not be standardized due to the complexity of the upper airway in these children, which should allow for cautious interpretation of the treatment outcomes as determined by the PSG findings. The lack of standardization of the surgical procedures in this population is an issue that have been addressed previously (Nada et al, 2009). Finally, although 26/35 children had imaging of the head, either Magnetic Resonance imaging (n ¼ 8) or computerized tomography (CT) (n ¼ 18); this was done for pre-operative purposes and was not intended to specify upper airway obstruction or soft tissue enlargement in those with OSA, clearly another important area for future research.…”

Section: Discussionmentioning

confidence: 99%

Sleep-related disordered breathing in children with syndromic craniosynostosis

Al-Saleh

Riekstins

Forrest

et al. 2011

Journal of Cranio-Maxillofacial Surgery

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Section: Discussionmentioning

confidence: 99%

Sleep-related disordered breathing in children with syndromic craniosynostosis

Al-Saleh

Riekstins

Forrest

et al. 2011

Journal of Cranio-Maxillofacial Surgery

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“…performed 12 bimaxillary procedures while patients were under general anaesthesia with nasal intubation. The surgical technique was chosen on the basis of the personal experience of the surgeon, by comparing surgical techniques reported in literature (Kahnberg, 1997;Landes et al, 2008aLandes et al, , 2008bNada et al, 2010;Gilles et al, 2013). The surgeon prepared and dissected the subperiosteum as usual before performing the bilateral sagittal split osteotomy (BSSO), and the mandibular osteotomy was initiated at 45 on the lingual ramus side.…”

Section: Surgical Methodsmentioning

confidence: 99%

Comparison of piezosurgery and traditional saw in bimaxillary orthognathic surgery

Spinelli

Lazzeri

Conti

et al. 2014

Journal of Cranio-Maxillofacial Surgery

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a b s t r a c tPurpose: Investigators have hypothesised that piezoelectric surgical device could permanently replace traditional saws in conventional orthognathic surgery. Methods: Twelve consecutive patients who underwent bimaxillary procedures were involved in the study. In six patients the right maxillary and mandible osteotomies were performed using traditional saw, whilst the left osteotomies by piezoosteotomy; in the remaining six patients, the surgical procedures were reversed. Intraoperative blood loss, procedure duration time, incision precision, postoperative swelling and haematoma, and nerve impairment were evaluated to compare the outcomes and costs of these two procedures. Results: Compare to traditional mechanical surgery, piezoosteotomy showed a significant intraoperative blood loss reduction of 25% (p ¼ 0.0367), but the mean surgical procedure duration was longer by 35% (p ¼ 0.0018). Moreover, the use of piezoosteotomy for mandible procedure required more time than for the maxillary surgery (p ¼ 0.0003). There was a lower incidence of postoperative haematoma and swelling following piezoosteotomy, and a statistically significant reduction in postoperative nerve impairment (p ¼ 0.003). Conclusions: We believe that piezoelectric device allows surgeons to achieve better results compared to a traditional surgical saw, especially in terms of intraoperative blood loss, postoperative swelling and nerve impairment. This device represents a less aggressive and safer method to perform invasive surgical procedures such as a Le Fort I osteotomy. However, we recommend the use of traditional saw in mandible surgery because it provides more foreseeable outcomes and well-controlled osteotomy. Further studies are needed to analyse whether piezoosteotomy could prevent relapse and promote bony union in larger advancements. Ó

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“…18,35 Distraction osteogenesis is the surgical induction of bone growth by applying distractive force across an osteotomy site, and this technique is becoming more common for expanding the cranium and for advancing the midface. 2,14,15,22,29,31,33,38,40,42,49 Distraction osteogenesis is a historical outgrowth of various methods of fracture reduction and retention that date back almost 2000 years. 48 Elective osteotomy combined with mechanical traction was used for femoral lengthening as early as 1905; 11 however, this technique was abandoned because of a high complication rate.…”

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confidence: 99%

Cranial vault expansion by distraction osteogenesis

Winston

Ketch

Dowlati³

2011

PED

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Object The object of this report is to present a conceptual and technical approach for expanding the cranial vault, by distraction osteogenesis, in patients with craniocephalic disproportion secondary to pancraniosynostosis and in patients with complex syndromic craniofaciosynostoses undergoing operations for aesthetic improvement. Methods The clinical characteristics, techniques used, outcome and complications for all patients who underwent cranial vault expansions with distraction osteogenesis in Children's Hospital of Denver were reviewed. Results Twenty-six cranial vault expansions were done in 24 patients. Nineteen patients presented with intracranial hypertension. Twelve of these had pancraniosynostosis and 8 had a syndromic diagnosis. Large segments of cranial bone were translated in a controlled manner for distances up to 30 mm. All but one of the patients with intracranial hypertension experienced complete resolution. Conclusions Cranial vault expansion by distraction osteogenesis has the great advantage, as the name implies, of generating new and vascularized autologous bone of the correct shape and in correct locations. The technique, although not simple and not risk free, is much less technically complicated and places patients at lower risk for the most serious complications than does single-stage vault expansion. Less soft tissue dissection and less devascularization of bone are required and there are no postoperative dead spaces. Distraction osteogenesis facilitates far greater vault expansions than do single-stage procedures and can be accomplished in any desired direction.

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Current practice of distraction osteogenesis for craniofacial anomalies in Europe: A web based survey

Cited by 47 publications

References 20 publications

Sleep-related disordered breathing in children with syndromic craniosynostosis

Sleep-related disordered breathing in children with syndromic craniosynostosis

Comparison of piezosurgery and traditional saw in bimaxillary orthognathic surgery

Cranial vault expansion by distraction osteogenesis

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