Unilateral Coronal Synostosis Treated by Internal Forehead Distraction

Kobayashi, Seiichiro; Honda, Takayuki; Saitoh, A.; Kashiwa, Katuhiko

doi:10.1097/00001665-199911000-00002

Cited by 54 publications

(16 citation statements)

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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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confidence: 99%

Cranial vault expansion by distraction osteogenesis

Winston

Ketch

Dowlati³

2011

PED

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“…On the other hand, our experience also suggests that attempts to reduce the extent of surgery in less severely affected regions produce unsatisfactory results: In metopic synostosis, even in cases with only mild disproportion, reshaping of the supraorbital rim is mandatory. Some authors recommend ipsilateral repair alone in unilateral coronal synostosis [9,14]. Marchac, however, proved involvement of both sides [10].…”

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confidence: 99%

Technical Aspects and Results of Surgery for Craniosynostosis

Haberl¹,

Hell²,

Zöckler³

et al. 2004

Zentralbl Neurochir

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“…Various techniques of plagiocephaly correction have been described, such as unilateral/bilateral frontal bone monoblock advancement, supraorbital rim advancement, or distraction osteogenesis using the same procedures. 7,8 Making an optimal and symmetrical curvature with the healthy sides is difficult. If patients with unilateral coronal synostosis reach adulthood, upper facial asymmetry may cause mid-and lower-facial asymmetry and problems with the temporomandibular joint.…”

Section: Discussionmentioning

confidence: 99%

Occipitofrontal Switching for Simultaneous Correction of Synostotic Frontal and Occipital Plagiocephaly: A Novel Surgical Technique

Kim

Park

2010

Craniomaxillofacial Trauma & Reconstruction

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Plagiocephaly has traditionally been corrected by unilateral or bilateral frontal bone advancement or rotation using bone-molding forceps and distraction devices. Complete symmetrical correction of deformed frontal bones is considered almost impossible because the curvature of each frontal bone varies. We evaluated the feasibility of measuring the optimal curvature of frontal and occipital bones using a plaster skull model and applying these measurements to ''switch'' them for simultaneous correction of frontal and occipital plagiocephaly. A 2-year-old girl suffering from unifrontal flattening visited our clinic. Unilateral coronal synostosis was observed. The 3-D rapid prototype model and skull replica method using thin paper clay were used for preplanned virtual surgery. The triangular bone was harvested from the contralateral bulging side of the occipital bone (''occipitofrontal switching'') for the best optimal curvature in the affected frontal bone. Another triangular bone was harvested from the ipsilateral flattened side of the frontal bone, and bones were switched with each other. Further bending of the frontal or occipital segment was not necessary for optimal curvature. Symmetrical correction was made by switching the triangular bone of the frontal area with that of the contralateral occipital area. Revision has not been necessary, and infection was not observed at 1-year follow-up. Our novel technique of preplanning surgery using a 3-D plaster model for simultaneous correction of frontal and occipital plagiocephaly is effective and time-saving.

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Unilateral Coronal Synostosis Treated by Internal Forehead Distraction

Cited by 54 publications

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Cranial vault expansion by distraction osteogenesis

Cranial vault expansion by distraction osteogenesis

Technical Aspects and Results of Surgery for Craniosynostosis

Occipitofrontal Switching for Simultaneous Correction of Synostotic Frontal and Occipital Plagiocephaly: A Novel Surgical Technique

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