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Cranial growth after distraction osteogenesis of the craniosynostosis

 Yong Oock Kim  ;  Jong Woo Choi  ;  Dong Seok Kim  ;  Won Jae Lee  ;  Sun-Kook Yoo  ;  Hee-Joong Kim  ;  Joong-Eun Choi  ;  Beyoung yun Park 
 JOURNAL OF CRANIOFACIAL SURGERY, Vol.19(1) : 45-55, 2008 
Journal Title
Issue Date
Cephalometry ; Child, Preschool ; Computer-Aided Design ; Cranial Sutures/abnormalities ; Cranial Sutures/surgery ; Craniosynostoses/surgery* ; External Fixators ; Follow-Up Studies ; Frontal Bone/abnormalities ; Frontal Bone/surgery ; Humans ; Image Processing, Computer-Assisted/methods ; Imaging, Three-Dimensional/methods ; Infant ; Longitudinal Studies ; Occipital Bone/abnormalities ; Occipital Bone/surgery ; Osteogenesis, Distraction*/instrumentation ; Parietal Bone/abnormalities ; Parietal Bone/surgery ; Patient Care Planning ; Skull/growth & development* ; Tomography, X-Ray Computed/methods ; Treatment Outcome
Craniosynostosis ; distraction ; growth
The authors describe the continuance of the growth of the distracted cranium after the reshaping of the cranium by distraction osteogenesis (DO) in children with simple symmetric and asymmetric craniosynostosis. From 2000 until 2002, 9 children with simple craniosynostosis underwent cranial reshaping by gradual distraction using an external distraction device. Four patients have symmetric deformities caused by bicoronal and sagittal craniosynostosis, and 5 patients have asymmetric deformities caused by unicoronal and unilambdoidal craniosynostosis. The distraction device was developed and applied by the author. Preoperative simulation surgery was done on the three-dimensional rapid prototyped model and on the three-dimensional computerized tomography scan to determine the favorable osteotomy line. The distraction rate was from 1 to 1.5 mm/d, and the latency period was from 1 to 5 days. The extent of distraction was determined on the basis of the results of simulation surgery and the change of external appearance. Evaluation of the growth of reshaped cranium was processed from the data of the reconstructed three-dimensional computerized tomography scans before operation, immediate end of distraction, and the last follow-up time. The anteroposterior length and bitemporal width were measured in symmetric synostosis cases, and the distance from supratrochlear notch to occiput was measured in asymmetric synostosis cases. The results showed that the immediate morphologic changes of cranium after DO were maintained in both symmetric and asymmetric synostosis up to the last follow-up without evidence of relapse. Cases of asymmetric deformity also showed that the affected side and the unaffected side had grown with the maintenance of the symmetry that was corrected at the immediate end of the distraction. The cranium modified by the DO was well maintained with the children's growth without any signs of recurrent restricted growth of the original disease. The corrected symmetry of asymmetric deformity was well maintained during a long-term follow-up period as well
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1. College of Medicine (의과대학) > Dept. of Medical Engineering (의학공학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Seok(김동석)
Kim, Yong Oock(김용욱) ORCID logo https://orcid.org/0000-0002-3756-4809
Kim, Hee Joung(김희중)
Park, Beyoung Yun(박병윤)
Yoo, Sun Kook(유선국) ORCID logo https://orcid.org/0000-0002-6032-4686
Lee, Won Jai(이원재) ORCID logo https://orcid.org/0000-0003-3056-0503
Choi, Joong Uhn(최중언)
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