A Case Report of RED II Distraction Osteogenesis and Early Rigid Fixation by Minimal Invasive Approach Le Fort III Osteotomy in Crouzon's Disease
Journal of the Korean Society of Plastic and Reconstructive Surgeons
; : 123-127, 2007.
Article
en Ko
| WPRIM
| ID: wpr-142250
Biblioteca responsable:
WPRO
ABSTRACT
PURPOSE: Rigid external distraction(RED) is a highly effective technique for correction of maxillary hypoplasia in patients with cleft or syndromic craniosynostosis. Despite many advantages of RED, it also has the problem of relapse as the conventional advancement surgery. Bicoronal approach, that is the common approach to gain access to the craniofacial skeleton, had some morbidity, such as hair loss, sensory loss, wide scar and temporal hollowing. We present our clinical experience of RED distraction with minimal invasive approach and early rigid fixation to overcome these disadvantages. METHODS: A 27-year-old female patient with Crouzon's disease underwent Le Fort III osteotomy and RED device application through the minimal invasive direct skin incisions. After the latent period of 5 days, distraction was undertaken until proper convexity and advancement were obtained. During the rigid retention period, inflammation occurred on the right cheek, and proper conservative managements were done including continuous irrigation. To maintain the stability of distraction, early rigid fixation was undertaken on the osteotomy sites through another skin incisions. Preoperative and postoperative orthodontic treatments were performed. Serial photographs and cephalometric radiographs were obtained preoperatively, after distraction and 6 months after distraction. RESULTS: The cephalometric analysis demonstrated postoperatively significant advancement of the maxilla and improvement of facial convexity. After 6-month follow-up period, the maxilla was stable in the sagittal plane and no relapse was found. Facial scars were not noticeable and other deformity and morbidity did not occur. CONCLUSION: This effective and stable technique will be a good alternative for the patients who need large amount of distraction and for adult patients with severe maxillary hypoplasia or syndromic craniosynostosis.
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Texto completo:
1
Índice:
WPRIM
Asunto principal:
Osteotomía
/
Recurrencia
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Esqueleto
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Piel
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Anomalías Congénitas
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Mejilla
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Estudios de Seguimiento
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Cicatriz
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Osteogénesis por Distracción
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Disostosis Craneofacial
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Adult
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Female
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Humans
Idioma:
Ko
Revista:
Journal of the Korean Society of Plastic and Reconstructive Surgeons
Año:
2007
Tipo del documento:
Article