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Dual midfacial distraction osteogenesis for Crouzon syndrome: long-term follow-up study for relapse and growth

Authors
 Dong Won Lee  ;  Ki Weon Ham  ;  Soon Man Kwon  ;  Dae Hyun Lew  ;  Eul Je Cho 
Citation
 JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, Vol.70(3) : 242-251, 2012 
Journal Title
JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY
ISSN
 0278-2391 
Issue Date
2012
MeSH
Adolescent ; Cephalometry ; Child ; Craniofacial Dysostosis/surgery* ; External Fixators ; Facial Bones/growth & development* ; Facial Bones/surgery ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Male ; Maxillofacial Development* ; Osteogenesis, Distraction/instrumentation ; Osteogenesis, Distraction/methods* ; Retrospective Studies ; Secondary Prevention ; Treatment Outcome
Keywords
Adolescent ; Cephalometry ; Child ; Craniofacial Dysostosis/surgery* ; External Fixators ; Facial Bones/growth & development* ; Facial Bones/surgery ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Male ; Maxillofacial Development* ; Osteogenesis, Distraction/instrumentation ; Osteogenesis, Distraction/methods* ; Retrospective Studies ; Secondary Prevention ; Treatment Outcome
Abstract
PURPOSE: Rigid external distraction osteogenesis is regarded as a standard treatment for congenital midfacial hypoplasia. However, external distraction for the upper portion of the midface is not as effective and tends to rotate the midfacial segment in a counterclockwise direction. Moreover, patients poorly tolerate it because of the device's bulkiness. To prevent such drawbacks of an external distractor, both external and internal distractors were synchronously applied to patients with Crouzon syndrome.

PATIENTS AND METHODS: In 6 patients with Crouzon syndrome in whom a dual-distraction technique was applied, distraction of the midfacial region was performed for up to a mean length of 15.3 mm. The external distractor was removed after a 1-month consolidation period, but the internal distractor was maintained for more than 6 months. The degree of advancement of the midface and ossification was measured with lateral cephalometry and 3-dimensional computed tomography imaging, respectively.

RESULTS: At long-term follow-up (mean, 4.6 years), the facial contours retained the initial distraction geometry with almost no relapse, showing that the ideal facial contour and occlusion could be obtained. Bone deposition was found to be continually progressing even 6 months postoperatively, and more than 6 months of consolidation was required for complete ossification that mainly occurred in the pterygomaxillary junction and lateral orbital wall.

CONCLUSIONS: The dual-distraction technique can induce balanced growth without the recurrence of hypoplasia, and it may eventually yield satisfactory outcomes in Crouzon syndrome.
Full Text
http://www.sciencedirect.com/science/article/pii/S0278239111017484
DOI
22374067
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Lew, Dae Hyun(유대현)
Lee, Dong Won(이동원) ORCID logo https://orcid.org/0000-0003-0046-3139
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91024
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