Advancement of the Orbits and the Midface in One Piece, Combined With Frontal Repositioning, for the Correction of Crouzonʼs Deformities

Ortiz‐Monasterio, Fernando; Af, del Campo; Carrillo, A. Jover

doi:10.1097/00006534-197804000-00003

Cited by 264 publications

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“…Many, such as the Apert and Crouzon patients, also have severe mid-face deformities, making it difficult to achieve or even judge the proper amount of frontal and superior orbital advancement, whether done as the initial operation or as a combined monobloc advancement. 14 There is still not a consensus as to the optimal timing and approach for these patients. 8,[15][16][17][18][19] The unilateral and bilateral lambdoid synostosis patients did well overall, although the unilateral lambdoid synostosis group did have a 6.7% complication rate, and two patients required unplanned reoperation.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Craniosynostosis: Outcome Analysis of 250 Consecutive Patients

Sloan¹,

et al. 1997

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ABSTRACT. Objective. Surgery for craniosynostosis has evolved rapidly over the past two decades, with increased emphasis on early, extensive operations. Older published series may not accurately reflect more recent experience. Our study was designed to analyze outcome in a large series of consecutive patients treated recently at a single center.Methods. We reviewed 250 consecutive patients who underwent surgical treatment of craniosynostosis between January 1, 1987 and December 31, 1992. They were divided into nine groups by suture involvement: sagittal, unilateral coronal, bilateral coronal, unilateral lambdoid, bilateral lambdoid, metopic, multiple suture, the Kleeblattschädel deformity (cloverleaf skull), and acquired craniosynostosis. Outcome was analyzed in terms of residual deformities and irregularities, complications, mortality, as well as the need for additional surgery.Results. There were 157 males (62.8%) and 93 females (37.2%), with most of the male preponderance accounted for by the large sagittal synostosis group, which consisted of 82 males and 25 females. Median age at first operation was 147 days. A named syndrome was present in 23 patients (9.2%) and was more common than expected with bilateral and unilateral coronal synostosis, the Kleeblattschädel deformity, and multiple suture synostosis. There were two deaths (0.8%), both with Kleeblattschädel patients, and 17 other complications (6.8%). Morbidity and mortality were significantly associated with secondary vs primary operations and syndromic vs nonsyndromic patients. Outcome analysis revealed the best surgical results with metopic synostosis and significantly less good results with the Kleeblattschädel deformity, multiple suture synostosis, and bilateral coronal synostosis.Conclusions. Using modern surgical techniques, craniosynostosis can be corrected with good outcomes and relatively low morbidity and mortality, particularly for otherwise healthy, nonsyndromic infants. Pediatrics 1997;100(1). URL: http://www.pediatrics.org/cgi/content/ full/100/1/e2; craniosynostosis, craniofacial anomalies, craniofacial surgery, facial deformities.

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Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Craniosynostosis: Outcome Analysis of 250 Consecutive Patients

Sloan¹,

et al. 1997

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“…During surgery, the splint is fixed to the maxillary bone by means of titanium screws. The incision is performed and a classic osteotomy, for the separation in monobloc, 20 culminating in the complete mobilization of the skeletal segment. The rigid fixation between the frontal bone and the supraorbital protuberances is done by the installation of three titanium plates (Fig 2B).…”

Section: Do For Midface Advancement In Monoblocmentioning

confidence: 99%

Treatment of midfacial hypoplasia in syndromic and cleft lip and palate patients by means of a rigid external distractor (RED)

Sant’Anna

Cury-Saramago

Lau

et al. 2013

Dental Press J. Orthod.

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INTRODUCTION: Distraction Osteogenesis (DO) became an alternative for the treatment of severe craniofacial skeletal dysplasias. The rigid external distraction device (RED) is successfully used to advance the maxilla and all the maxillary-orbital-frontal complex (monobloc) in children, adolescents and adults. This approach provides predictable and stable results, and it can be applied alone or with craniofacial orthognathic surgical procedures. OBJECTIVE: In the present article, the technical aspects relevant to an adequate application of the RED will be described, including the planning, surgical and orthodontic procedures.

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“…However, these procedures have high morbidity, with the possibility of several complications related to dead space between the dura mater and cap grafts 6 . Furthermore, static remodeling causes cavity expansion that does not always adequately meet the actual requirement.…”

Section: Introductionmentioning

confidence: 99%

Nautilus: craniotomia dinâmica - nova técnica cirúrgica e resultados preliminares

Cardim¹,

Silva

Salomons

et al. 2013

Rev. Bras. Cir. Plást.

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Nautilus-shaped dynamic craniotomy: a new surgical technique and preliminary resultsNautilus: craniotomia dinâmica -nova técnica cirúrgica e resultados preliminares ABSTRACT Introduction: Considering that craniosynostosis is a suture-related condition, the main challenge for its treatment is the fact that the brain is located in a closed compartment that does not have the required adaptability to accommodate its growth. The goal of treat ment is to restore stenotic suture adaptability and correct the compensatory cranial deformity. This paper proposes the combined use of spiral osteotomy with distraction osteogenesis by the use of distracting springs to remodel craniofacial defects caused by craniosynostosis. Methods: Between July 2010 and July 2012, 10 patients with craniosynostosis were treated: 5 with oxycephaly, 3 with scaphocephaly, 1 with turricephaly, and 1 with trigonocephaly. The treatment consisted of the application of Lauritzen springs to correct the primary craniosynostosis defect in combination with a nautilus-shaped spiral craniotomy at the secondary deformation sites without dural detachment. Results: Resolution of cranial deformity and remission of the clinical signs of intracranial hypertension were observed. None of the patients had complications such as cerebrospinal fluid fistula, local infection, seroma, or hematoma. Conclusions: The combined use of spiral osteotomy with spring-mediated distraction or contraction enables active reshaping of the skull and facilitates accommodation of the brain by the cranial cavity. (clinicaltrials.gov identifier: NCT01672619) Keywords: Craniosynostoses. Osteogenesis, distraction. Craniotomy. RESUMOIntrodução: Considerando-se que as craniossinostoses são afecções basicamente suturais, o fato de o cérebro estar aprisionado em um compartimento fechado, que não possui a complacência necessária para acompanhar seu crescimento, se constitui no desafio principal de seu tratamento. O objetivo do tratamento é restabelecer a complacência da sutura estenótica e corrigir a deformidade craniana compensatória. Este trabalho propõe a associação de osteotomia helicoide à distração osteogênica proporcionada pelo uso das molas distratoras para remodelar defeitos craniofaciais causados por craniossinostoses. Método: Entre julho de 2010 e julho de 2012, foram tratados 10 pacientes portadores de craniossinostoses, sendo 5 oxicefalias, 3 escafocefalias, 1 turricefalia e 1 trigonocefalia. O tratamento consistiu na aplicação de molas de Lauritzen, para corrigir a deformidade primária da craniossinostose, com a associação de craniotomia helicoide em forma de Nautilus nos sítios de deformação secundária do crânio, sem descolamento dural. Resultados: Foi observada resolução da deformidade craniana e remissão dos sinais clínicos de hipertensão intracraniana. Nenhum

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Advancement of the Orbits and the Midface in One Piece, Combined With Frontal Repositioning, for the Correction of Crouzonʼs Deformities

Cited by 264 publications

References 0 publications

Surgical Treatment of Craniosynostosis: Outcome Analysis of 250 Consecutive Patients

Surgical Treatment of Craniosynostosis: Outcome Analysis of 250 Consecutive Patients

Treatment of midfacial hypoplasia in syndromic and cleft lip and palate patients by means of a rigid external distractor (RED)

Nautilus: craniotomia dinâmica - nova técnica cirúrgica e resultados preliminares

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