Frontofacial monobloc advancement using gradual bone distraction method

Kamoshima, Yuuta; Sawamura, Yutaka; Yoshino, Masami; Kawashima, Koichiro

doi:10.1016/j.jpedsurg.2008.06.018

Cited by 14 publications

(10 citation statements)

References 16 publications

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“…The patient went on to have a monobloc advancement and calvarial reconstruction followed by the application of a rigid external distraction frame for 2 months with an excellent cosmetic result in keeping with the literature [4]. Six months after surgery, the headaches and papilloedema have resolved, as has the sleep apnoea.…”

Section: Treatment and Outcomesupporting

confidence: 58%

Sinus Hypoplasia and Intracranial Hypertension in Pycnodysostosis (SHIHP): A New Disease Process?

Bahl¹,

Olubajo²,

Connolly³

et al. 2013

Ann Paediatr Rheum

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Pycnodysostosis is a rare autosomal recessive skeletal dysplasia caused by absence of active cathepsin K. Intracranial hypertension represents a rarely reported, life threatening complication of pycnodysostosis. We describe, for the first time, two children with pycnodysostosis who presented with raised intracranial pressure and were found to have intracranial venous sinus hypoplasia. The combination of Sinus Hypoplasia and Intracranial Hypertension in Pycnodysostosis (SHIHP) has not been previously reported. In a patient with pycnodysostosis, neurological and ophthalmological assessment is necessary and MR Brain including venography should be considered. The management of such a patient is challenging in particular due to the uncertainty as to the mechanism of the raised intracranial pressure in the face of small ventricles and an open fontanelle. Multidisciplinary team management including the geneticist, ophthalmologist, neurologist, neurosurgeon, and the metabolic bone team is required. Surgical options include CSF diversion and cranial vault remodelling. The interplay of venous sinus hypoplasia, intracranial vault abnormalities, and raised intracranial pressure in a patient with pycnodysostosis shall be presented and discussed.

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Section: Treatment and Outcomesupporting

confidence: 58%

Sinus Hypoplasia and Intracranial Hypertension in Pycnodysostosis (SHIHP): A New Disease Process?

Bahl¹,

Olubajo²,

Connolly³

et al. 2013

Ann Paediatr Rheum

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“…An external distracter system (Blue Device, W. Lorenz Surgical) was used in 1 operation. 28,34 The median latency period (time between distracter implantation and the start of distraction) was 4 days (range 3-5 days). The median consolidation time was 66 days (range 4-155 days) in 25 operations.…”

Section: Methodsmentioning

confidence: 99%

“…36,39,43,45,49,51,53,54 Distraction osteogenesis is now most often accomplished with implanted jackscrew-type distracters that are incrementally advanced, but it can also be accomplished with external distraction devices. 28,34 In this article, the senior authors (K.R.W. and L.L.K.…”

mentioning

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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“…Kamoshima 149 describes the results of this intervention in 3 children as follows: “excellent functional and cosmetic outcome, with no remarkable complication.” Fitzgerald O’Conner described 10 syndromic craniosynostosis patients who underwent monobloc distraction. 150 The CT scans (pre- and postsurgery) demonstrated adequate advancement of the bony orbits, including forward advancement of the eyeball.…”

Section: Surgical Treatment Of Syndromic Craniosynostosis—the Cranmentioning

confidence: 99%