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Distraction vs remodeling surgery for craniosynostosis

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Abstract

Objects

We designed several distraction devices and applied these instruments in 14 patients with varying types of craniosynostosis. The aim of this report is to clarify the advantages and disadvantages of these surgical methods and to discuss current concepts for the surgical strategy in the treatment of craniosynostosis.

Methods

From January 2000 to July 2005, 28 patients with craniosynostosis were retrospectively analyzed. Surgical treatment was performed on 14 patients using the distraction method with internal distraction devices that we designed, in which 5 patients had plagiocephaly, 3 brachycephaly, and 6 scaphocephaly. All patients underwent preoperative and postoperative evaluations, which included the patient’s neurological state, and three-dimensional CT.

Results

With distraction devices, the time required for the surgery could be shortened almost 3 1/3 h; the bleeding during the surgery was decreased with reduced requirement of more than 200 ml of blood transfusion as compared with remodeling surgery. Postoperatively achieved distraction distances varied from 30.0 to 47.5 mm (mean, 42.99 mm). The average increased volume percent of cranium in distraction surgery group was 20.9% (range, −11.5 to 58.9%) after full distraction.

Conclusion

With distraction surgery, satisfactory cranial volume expansion and aesthetically pleasing morphological states were achieved in all cases, and the efficacy was statistically significantly high as compared with remodeling method.

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References

  1. Marie-Lannelongue (1890) De la craniectomie dans la microcephalie. CR Acad Sci (Paris) 110:1382

    Google Scholar 

  2. Reiner D, Lajeunie E, Arnaud E, Marchac D (2000) Management of craniosynostosis. Childs Nerv Syst 16:645–658

    Article  Google Scholar 

  3. Oi S, Matsumoto S (1987) Trigonocephlay (metopic synostosis). Clinical, surgical and anatomical concepts. Childs Nerv Syst 3:259–265

    Article  PubMed  CAS  Google Scholar 

  4. Persing JA, Edgerton MT, Park TS et al (1987) Barrel stave osteotomy for correction of turribrachycephaly craniosynostosis deformity. Ann Plast Surg 18:488–493

    Article  PubMed  CAS  Google Scholar 

  5. Tessier P (1971) The definitive plastic surgical treatment of the severe facial deformities of craniofacial dysostosis: Crouzon’s and Apert’s diseases. Plast Reconstr Surg 48:419–442

    Article  PubMed  CAS  Google Scholar 

  6. van der Meulen JC (1979) Medial fasciotomy. Br J Plast Surg 31:339–342

    Google Scholar 

  7. McCarthy JG, Schreiber J, Karp N, Thorne CH, Crayson BH (1992) Lengthening the human mandible by gradual distraction. Plast Reconstr Surg 89:1–10

    Article  PubMed  CAS  Google Scholar 

  8. Chin M, Toth BA (1997) Le Fort III advancement with gradual distraction using internal devices. Plast Reconstr Surg 100:819–830

    Article  PubMed  CAS  Google Scholar 

  9. Cohen SR, Doydston W, Hudgins R, Burstein FD (1999) Monobloc and facial bipartition distraction with internal devices. J Craniofac Surg 10:244–251

    Article  PubMed  CAS  Google Scholar 

  10. do Amaral CMR, Di Domizio G, Tiziani V et al (1997) Gradual bone distraction in craniosynostosis. Scand J Plast Reconstr Surg 31:25–37

    Article  Google Scholar 

  11. Gosain AK (2001) Distraction osteogenesis of the craniofacial skeleton. Plast Reconstr Surg 107:278–280

    Article  PubMed  CAS  Google Scholar 

  12. Gosain AK, Santoro TD, Havlik RJ, Cohen SR, Holmes RE (2004) Midface distraction following Le Fort III and monobloc osteotomies: problems and solutions. Plast Reconstr Surg 109:1797–1808

    Article  Google Scholar 

  13. Marchac D, Arnaud E (1999) Midface surgery from Tessier to distraction. Childs Nerv Syst 15:681–694

    Article  PubMed  CAS  Google Scholar 

  14. Nadal E, Dogliotti PLV, Rodriguez JC, Zuccaro G (2000) Craniofacial distraction osteogenesis en bloc. J Craniofac Surg 11:246–253

    Article  PubMed  CAS  Google Scholar 

  15. Talisman R, Hemmy DC, Denny AD (1997) Frontofacial osteotomies, advancement, and remodeling by distraction: an extended application of the technique. J Craniofac Surg 8:308–317

    Article  PubMed  CAS  Google Scholar 

  16. Hirabayashi S, Sugawara Y, Sakurai A, Harii K, Park S (1998) Frontoorbital advancement by gradual distraction. Technical note. J Neurosurg 89:1058–1061

    PubMed  CAS  Google Scholar 

  17. Homes AD, Wright GW, Meara JG, Heggie AA, Probert TC (2002) Le Fort III internal distraction in syndromic craniosynostosis. J Craniofac Surg 13:262–272

    Article  Google Scholar 

  18. Nonaka Y, Oi S, Miyawaki T, Shinoda A, Kurihara K (2004) Indication for and surgical outcomes of the distraction method in various types of craniosynostosis. Advantages, disadvantages, and current concepts for surgical strategy in the treatment of craniosynostosis. Childs Nerv Syst 20:702–709

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute for Surgical Research, Ludwig Maximilian University, Munich, Germany

    Seong-Woong Kim & Nick Plesnila

  2. Brain Korea 21 Project of Medical Science, Institute for Brain Research, College of Medicine, Yonsei University, Seoul, South Korea

    Dong-Seok Kim

  3. Department of Neurosurgery, Brain Korea 21 Project of Medical Science, Institute for Brain Research, College of Medicine, Yonsei University, Seoul, South Korea

    Kyu-Won Shim & Joong-Uhn Choi

  4. Department of Plastic Surgery, College of Medicine, Yonsei University, Seoul, South Korea

    Yong-Oock Kim

  5. Department of Neurosurgery, Yonsei University College of Medicine, 134 Sinchon-dong, Seodaemun-gu, Seoul, 120-752, South Korea

    Dong-Seok Kim

Authors
  1. Seong-Woong Kim
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  2. Kyu-Won Shim
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  3. Nick Plesnila
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  4. Yong-Oock Kim
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  5. Joong-Uhn Choi
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  6. Dong-Seok Kim
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Corresponding author

Correspondence to Dong-Seok Kim.

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Kim, SW., Shim, KW., Plesnila, N. et al. Distraction vs remodeling surgery for craniosynostosis. Childs Nerv Syst 23, 201–206 (2007). https://doi.org/10.1007/s00381-006-0209-1

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  • DOI: https://doi.org/10.1007/s00381-006-0209-1

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