SPRING MEDIATED DYNAMIC CRANIOFACIAL RESHAPING: Case report

Lauritzen, Christian; Sugawara, Yasuhiko; Kocabalkan, Oya; Olsson, Robert

doi:10.1080/02844319850158697

Cited by 174 publications

(91 citation statements)

References 4 publications

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“…In 1986, Persing et al 2 published an experimental study with implantable springs for skull expansion. In 1998 and 2003, Lauritzen et al 3 described two clinical cases of patients with craniosynostosis using dynamic expansion with implantable internal springs and in 2001, they reported an experimental study showing changes in the growth of rabbit skulls using springs 4 . In 2008, they published the first 100 cases using this device 5 .…”

Section: Introductionmentioning

confidence: 99%

Spring-mediated skull expansion: overall effects in sutural and parasutural areas. An experimental study in rabbits

Dornelles

Cardim

Trierveiler³

et al. 2010

Acta Cir. Bras.

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PURPOSE: The use of springs in cranial expansion has proven to be effective in the treatment of craniosynostosis. Spring-mediated expansion has been studied both in the sagittal and in parasagittal regions, especially in scaphocephaly. A rabbit model was used in the present study to analyze the effects of springs on the cranial vault and sutures. METHODS: Thirteen 4-week-old New Zealand rabbits were divided into 4 groups: in group I, only amalgam markers were used as control; in group II, amalgam markers were used and sagittal suturectomy was performed; in group III, amalgam markers were used, a sagittal suturectomy was performed and an expansible spring was fitted in the interparietal region and in group IV, markers were used and linear parasagittal craniectomy was carried out with springs. Animals were sacrificed after 2, 4, 8 and 12 weeks. Radiological control and histological analysis were performed in the area of spring implantation. RESULTS: In the groups using springs distraction of the craniectomy borders was greater than in those that did not use springs. New bone formation was observed in all groups, and was faster in group II. Bone growth started from the borders and depth. Bone regeneration presented a similar histological pattern in the groups with spring in the sagittal and parasagittal region. CONCLUSION: The rabbit model proved to be adequate for the analysis proposed by the study. The use of springs in the groups with sagittal and parasagittal osteotomy led to a similar distraction of amalgam markers and both groups had similar ossification histological pattern.

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Section: Introductionmentioning

confidence: 99%

Spring-mediated skull expansion: overall effects in sutural and parasutural areas. An experimental study in rabbits

Dornelles

Cardim

Trierveiler³

et al. 2010

Acta Cir. Bras.

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“…Furthermore, static remodeling causes cavity expansion that does not always adequately meet the actual requirement. Therefore, Lauritzen et al 7 proposed dynamic cranial remodeling using expan der springs in 1998. They applied the principles of osteotomy and interposition of metal springs, without detaching the dura, by inserting expansive forces on the stenotic lines that are distributed throughout the dura around the whole brain content/cavity to reshape the skull 7 .…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, Lauritzen et al 7 proposed dynamic cranial remodeling using expan der springs in 1998. They applied the principles of osteotomy and interposition of metal springs, without detaching the dura, by inserting expansive forces on the stenotic lines that are distributed throughout the dura around the whole brain content/cavity to reshape the skull 7 . Because of the ideal characteristics of the spiral shape for modeling convex surfaces, Salyer and Bardach 8 proposed its use in modeling osteotomies in scaphocephaly.…”

Section: Introductionmentioning

confidence: 99%

“…As described by Lauritzen et al 7 , the procedure involved 2 surgical steps: first, spring placement for nautilus-shaped dynamic osteotomy; and second, spring removal performed 6-12 months after the initial procedure. The timing of spring removal was determined according to the degree of ossification of the osteotomy and evaluated by 3-dimensional tomography of the skull.…”

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confidence: 99%

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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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“…The first clinical description of a cranioplasty using expansible springs dates back to 1998 (Lauritzen, Sugawara et al 1998), in which the principle of the dynamic expansion of internal implantable springs was used (Lauritzen, Sugawara et al 1998;Lauritzen and Tarnow 2003). This study consisted in linear craniectomies with spring interposition in order to stimulate bone edges in an expansive or compressive manner (or both).…”

Section: Expansible Springsmentioning

confidence: 99%