RESUMO
Eleven patients with syndromic craniosynostosis were treated with gradual distraction fronto-orbital advancement using "floating forehead." The frontal and supraorbital area was cut and remolded. Bony orbits were widened in three patients. Frontal bone was let floating on the dura and fixed loosely with absorbable threads to remolded supraorbital bone. A pair of distracters with hinge plates (A.V.D. system, Bear Medic Corp, Tokyo, Japan) was fixed between the temporal area and supraorbital bone. Distraction was begun 5 to 7 days after the surgery, and 1.8 to 3.2 cm advancement was obtained. Distracters were taken off after 3 to 7 weeks of consolidation periods. Although no major complication was encountered, some minor complications related to the devices were experienced.
Assuntos
Craniossinostoses/cirurgia , Testa/cirurgia , Osso Frontal/cirurgia , Órbita/cirurgia , Osteogênese por Distração/métodos , Implantes Absorvíveis , Placas Ósseas , Dura-Máter , Feminino , Seguimentos , Humanos , Lactente , Fixadores Internos , Ácido Láctico , Masculino , Osteotomia , Poliésteres , Polímeros , Osso Esfenoide/cirurgia , Telas Cirúrgicas , Suturas , Síndrome , Osso Temporal/cirurgia , TitânioRESUMO
PURPOSE: In this study, we performed alveolar bone grafting with autologous iliac cancellous bone incorporation with platelet-rich plasma (PRP) and evaluated its efficacy in osteoregeneration. MATERIALS AND METHODS: Seven alveolar cleft patients with adult dentition (average age, 16.1 years) underwent iliac bone grafting with PRP. Quantitative evaluation of regenerated bone was made with 3-dimensional computed tomography scans and compared with controls. RESULTS: The average of the volume ratio of regenerated bone to alveolar cleft in cases with PRP was higher than in controls (P <.05). There were no complications from the blood draw or PRP. CONCLUSION: PRP was a safe and cost-effective source for growth factors and was easy to extract. It could enhance the osteogenesis of alveolar bone grafting in cleft lip and palate patients and may useful for subsequent orthodontic therapy.
Assuntos
Alveoloplastia/métodos , Transplante Ósseo/métodos , Transfusão de Plaquetas , Adolescente , Processo Alveolar/anormalidades , Plaquetas/fisiologia , Regeneração Óssea/fisiologia , Fenda Labial/complicações , Fissura Palatina/cirurgia , Adesivo Tecidual de Fibrina/uso terapêutico , Seguimentos , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Adesivos Teciduais/uso terapêutico , Tomografia Computadorizada por Raios XRESUMO
Fronto-facial monobloc advancement is one of the most rewarding procedures for upper and mid-face reconstruction in patients with craniosynostosis. However, it has challenging aspects. Epidural abscess and frontal bone necrosis after retrofrontal dead space is one of the major complications and has led many experienced surgeons not to continue with the procedure. Bone distraction can play a great role in preventing these problems. The Rigid External Distraction (RED-II) system is a external distraction device using the cranium as an anchorage point. In two craniosynostosis cases, fronto-facial monobloc advancement with the system was performed. Controllability of the monobloc segment increased significantly. Operative time and blood loss were lessened. No major complications were experienced.
