Fronto-facial Monobloc Advancement With Rigid External Distraction (RED-II) System

Abstract

Fronto-facial monobloc advancement is one of the most rewarding procedures for upper and mid-face reconstruction in patients with craniosynostosis. However, it has challenging aspects. Epidural abscess and frontal bone necrosis after retrofrontal dead space is one of the major complications and has led many experienced surgeons not to continue with the procedure. Bone distraction can play a great role in preventing these problems. The Rigid External Distraction (RED-II) system is a external distraction device using the cranium as an anchorage point. In two craniosynostosis cases, fronto-facial monobloc advancement with the system was performed. Controllability of the monobloc segment increased significantly. Operative time and blood loss were lessened. No major complications were experienced.

Reduction of Morbidity of the Frontofacial Monobloc Advancement in Children by the Use of Internal Distraction

“…It has gained wide acceptance, and promotors of external distractors have reported quite satisfactory results with the use of the rigid external distraction system. [37][38][39][40] In our unit, internal devices have been used since the very beginning because they were more applicable in our youngest patients, those younger than 1 year. There is little doubt that at this young age, an external device, even reduced in size, is inadequate.…”

Frontofacial monobloc advancement using gradual bone distraction method

“…Recently, this system has been applied for the midface distraction after Le Fort III or monobloc osteotomies [14]. We used this rigid external distraction device with 2 pairs of distraction port to advance a monobloc frontofacial bone.…”

A novel skeletal anchorage for rigid external distractor

“…Nevertheless, as Nishimoto et al [18] emphasised, the presence of teeth is ideal because it diminishes the chance of relapse, since occlusion holds skeletal bases in position. Furthermore, they state that when teeth are missing, consolidation time should be longer.…”