Multidirectional Cranial Distraction Osteogenesis with Simplified Modifications for Treating Sagittal Synostosis

Sunaga, Ataru; Sugawara, Yasuhiko; Kamochi, Hideaki; Gomi, Akira; Chi, Daekwan; Asahi, Rintaro; Mori, Masanori; Sarukawa, Shunji; Uda, Hirokazu

doi:10.1097/gox.0000000000001536

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…We previously described the MCDO procedure. 2 , 3 , 4 Recently in the MCDO procedure, the setting of the osteotomy line is divided into 9 flaps: the anterior-posterior direction is divided into 3 rows of anterior, middle, and posterior segments, and the medio-lateral direction is divided into 3 columns of right, middle, and left segments. In this case, only the cortical osteotomy was used between the anterior and central segments in the central row to avoid any steps, and the two segments were almost entirely in 1 flap.…”

Section: Discussionmentioning

confidence: 99%

“…At 2 years and 8 months, the multi-directional cranial distraction osteogenesis (MCDO) procedure was performed as described previously. 2 , 3 , 4 Briefly, a coronal incision was made, and the entire cranium was divided into 9 bone flaps with a bone saw and an ultrasonic bone scalpel (Sonopet; Stryker, Kalamazoo, Mich.). The supraorbital hyperostosis was shaved with a burr.…”

Section: Case Reportmentioning

confidence: 99%

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Multi-directional Cranial Distraction Osteogenesis for Treating Sagittal Synostosis with Frontometaphyseal Dysplasia: A Case Report

Morishita

Sunaga

Gomi

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Summary: Frontometaphyseal dysplasia (FMD), also known as Gorlin-Cohen syndrome, is a rare genetic syndrome. This syndrome affects the skeletal system and connective tissue, and causes a wide spectrum of manifestations of the skull, tubular bones, cardiovascular system, urinary system, and/or gastrointestinal system. Craniofacial findings of FMD are characterized by protruding supraorbital ridge, broad nasal bridge, hypertelorism, down-slanting palpebral fissures, and/or micrognathia. We describe a case of a 2-year-old girl diagnosed with sagittal synostosis accompanied with FMD. She presents anterior sagittal synostosis cranial form, compressed cerebrospinal fluid space (which suggested increased intracranial pressure), and the supraorbital hyperostosis. She underwent multi-directional cranial distraction osteogenesis in the calvaria and shaving of the supraorbital ridges. Despite concerns about bone fragility associated with FMD, the surgery was accomplished as usual. The patient had no intra- and postoperative complications. After 6 months of follow-up, the cranial shape has improved and the cerebrospinal fluid space has widened, but the supraorbital ridge has protruded again. Re-protrusion of the supraorbital ridge appears to be due to age-appropriate vigorous osteogenesis. The multi-directional cranial distraction osteogenesis procedure has been useful for treating sagittal synostosis even concomitant with FMD.

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Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Multi-directional Cranial Distraction Osteogenesis for Treating Sagittal Synostosis with Frontometaphyseal Dysplasia: A Case Report

Morishita

Sunaga

Gomi

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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“…Long-term outcomes suggest promising results, but are compromised by single-center designs and no comparison group [55,56]. Distraction osteogenesis, a commonly described technique for syndromic craniosynostosis [57,58], has also been used for single-suture synostosis [59][60][61]. However, the few studies with more long-term results are underpowered and lack control groups [62][63][64].…”

Section: Discussionmentioning

confidence: 99%

Short- and Long-Term Outcomes by Procedure Type for Nonsagittal Single-Suture Craniosynostosis

Bennett

Hespe

Vercler

et al. 2019

Journal of Craniofacial Surgery

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Background: Minimally invasive approaches for the treatment of single-suture craniosynostosis are sometimes touted as equivalent to cranial vault reconstruction. While techniques for sagittal synostosis have been reviewed previously, evidence regarding open and less invasive surgical techniques for metopic, coronal, and lambdoid synostosis has yet to be reviewed. Methods: Systematic searches were performed using Embase.com and PubMed. Included studies reported short-or long-term outcomes, compared at least two standard techniques, discussed single-suture coronal, metopic, or lambdoid craniosynostosis, and enrolled at least 20 study participants. Two authors screened titles and abstracts, and also performed full text review and data extraction. Given heterogeneous outcomes, qualitative synthesis was performed after data extraction. Results:The search strategy yielded 2,348 articles. Of these, 313 were removed as duplicates, and 1,935 were excluded during title/abstract review. After full text review of 100 articles, 19 were selected for data extraction. The heterogeneity of outcomes precluded meta-analysis and required qualitative synthesis. While short-term outcomes indicated decreased morbidity of minimally invasive techniques, only two articles presented long-term reoperation rates. One study reported higher reoperation rates in the less invasive technique, and the second reported no reoperations in the median follow-up period of 33 months.Conclusions: Studies comparing long-term outcomes between different surgical techniques for single-suture craniosynostosis remain deficient. The development of standardized outcome measures is essential, and prospective, multicenter studies are necessary to assess the long-term efficacy of these procedures.

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Multidirectional cranial distraction osteogenesis technique for treating bicoronal synostosis

Sunaga

Sugawara²,

Gomi

et al. 2019

Journal of Cranio-Maxillofacial Surgery

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Multidirectional Cranial Distraction Osteogenesis with Simplified Modifications for Treating Sagittal Synostosis

Abstract: Supplemental Digital Content is available in the text.

Cited by 4 publications

References 18 publications

Multi-directional Cranial Distraction Osteogenesis for Treating Sagittal Synostosis with Frontometaphyseal Dysplasia: A Case Report

Multi-directional Cranial Distraction Osteogenesis for Treating Sagittal Synostosis with Frontometaphyseal Dysplasia: A Case Report

Short- and Long-Term Outcomes by Procedure Type for Nonsagittal Single-Suture Craniosynostosis

Multidirectional cranial distraction osteogenesis technique for treating bicoronal synostosis

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