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Cranial distraction

Qing Wang, Xinjie Wu, Mingsheng Tan, Gaoju Wang, Shuang Xu, Yingna Qi
OBJECTIVE: To describe lower cranial nerve palsy (LCNP) following vertical over-distraction when performing occipitocervical fusion (OCF) to treat vertical atlantoaxial dislocation (AAD) and basilar invagination (BI) and to investigate its possible causes. METHODS: We report 4 cases with vertical AAD and BI who postoperatively presented with neurogenic dysphagia, dysarthria, and bucking after undergoing anatomical reduction. RESULTS: Patients underwent revision surgery to achieve partial reduction and demonstrated remarkable recovery of 9th , 10th and 11th nerve deficits...
March 7, 2018: World Neurosurgery
Netanja S Ter Maaten, Daniel M Mazzaferro, Ari M Wes, Sanjay Naran, Scott P Bartlett, Jesse A Taylor
BACKGROUND: Posterior vault distraction osteogenesis (PVDO) is believed to improve frontal contour in infants with syndromic craniosynostosis and turribrachycephaly. This study provides an objective craniometric analysis to determine how PVDO affects anterior cranial morphology. METHODS: A retrospective chart review of patients who underwent PVDO was performed. Inclusion criteria included pre- and postoperative computed tomography (CT) scans within 3 months before surgery and another 1 to 6 months after device removal...
March 8, 2018: Journal of Craniofacial Surgery
Michael G Brandel, Cecilia L Dalle Ore, Chris M Reid, Wendy W Zhang, William Zhu, Chinwe S Kpaduwa, Samuel Lance, Hal S Meltzer, Amanda A Gosman
INTRODUCTION: Methods of reporting quantitative results for distraction osteogenesis (DO) of craniosynostosis have been inconsistent. Therefore, the efficacy of differing techniques and timing in regard to volume change is not well established, with no uniform metric for comparisons. Given that cranial vault remodeling with DO may be completed with different approaches, analysis was made to determine (1) the relative efficiency of different approaches in expanding intracranial volume (ICV) and (2) the impact of adjusting for ICV growth on measured DO efficiency...
February 27, 2018: Annals of Plastic Surgery
Malke Asaad, Samita Goyal, Kristen A Klement, Arlen D Denny
Crouzon syndrome (CS) is one of the craniosynostosis syndromes that leads to early fusion of cranial sutures and increased intracranial pressure. Intracranial hypertension is a serious complication that may lead to vision loss and cognitive impairment. Early detection and management are necessary to prevent complications. The authors present a patient with CS who underwent posterior cranial vault reconstruction with internal distraction after multiple episodes of headache and papilledema. The patient was unaware of any loss of color vision before the surgery; however, he noted an improvement in his color vision after the surgery...
February 26, 2018: Journal of Craniofacial Surgery
Michael J Foley, Patrick S Cottler, Silvia S Blemker, Arlen D Denny, Jonathan S Black
OBJECTIVE: The objective of this study was to validate the proof of concept of a computer-simulated cranial distraction, demonstrating accurate shape and end volume. DESIGN: Detailed modeling was performed on pre- and postoperative computed tomographic (CT) scans to generate accurate measurements of intracranial volume. Additionally, digital distraction simulations were performed on the preoperative scan and the resultant intracranial volume and shape were evaluated...
March 2018: Cleft Palate-craniofacial Journal
Tarek Elbanoby
BACKGROUND: The objective of this work is to present a review of all reports involving the management of unicoronal synostosis with distraction osteogenesis (DO). Also, we have innovated a new method in the treatment of cases of anterior plagiocephaly at a young age using DO. METHODS: We present a case in which anterior plagiocephaly was treated by DO of both metopic and hemicoronal sutures in a 4-month-old female patient. A comprehensive systematic literature review was completed using the search terms "distraction osteogenesis," "unicoronal synostosis," "anterior plagiocephaly," and "craniosynostosis...
February 7, 2018: Pediatric Neurosurgery
Rosaline S Zhang, Ari M Wes, Sanjay Naran, Ian C Hoppe, James Sun, Daniel Mazzaferro, Scott P Bartlett, Jesse A Taylor
PURPOSE: The purpose of this study was to evaluate the indications, safety, and short-term outcomes of posterior vault distraction osteogenesis (PVDO) in patients with no identified acrocephalosyndactyly syndrome (study) and to compare those to a syndromic cohort (controls). METHODS: Demographic and perioperative data were recorded and compared across the study and control groups for those who underwent PVDO between January 2009 and December 2016. Univariate analysis was conducted using χ and Fisher exact tests for categorical variables, and Mann-Whitney U test for continuous variables...
January 19, 2018: Journal of Craniofacial Surgery
Joshua D Cosman, Kaleb A Lowe, Geoffrey F Woodman, Jeffrey D Schall
Avoiding distraction by conspicuous but irrelevant stimuli is critical to accomplishing daily tasks. Regions of prefrontal cortex control attention by enhancing the representation of task-relevant information in sensory cortex, which can be measured in modulation of both single neurons and event-related electrical potentials (ERPs) on the cranial surface [1, 2]. When irrelevant information is particularly conspicuous, it can distract attention and interfere with the selection of behaviorally relevant information...
January 11, 2018: Current Biology: CB
Lucienne Gautier, Christoph Aufdenblatten, Stefan Dierauer, Leonhard Ramseier, Luca Mazzone, Hanspeter Huber, Mazda Farshad
CASE: Spinal fractures are rare in young children. Because spinal anatomy and biomechanics differ in children and adults, knowledge of the deviations of the juvenile spine is necessary for adequate treatment. We present the case of a young girl with an unusual C2 fracture that included rupture of both of the neurocentral and lateral dental synchondroses, with an opening of the synchondroses and a caudal dislocation of both vertebral arches following a head-on motor vehicle collision. The whole body and apex of the dens was displaced anteriorly and cranially with a kyphotic angulation of 34°...
October 2017: JBJS Case Connector
Ataru Sunaga, Yasushi Sugawara, Hideaki Kamochi, Akira Gomi, Daekwan Chi, Rintaro Asahi, Masanori Mori, Shunji Sarukawa, Hirokazu Uda, Kotaro Yoshimura
Background: Multidirectional cranial distraction osteogenesis (MCDO) is a procedure of ours developed earlier for treating craniosynostosis. However, the numerous bone flaps led to prolonged operative time and occasional bone detachment from dura. We have since simplified the osteotomy design. In treating sagittal synostosis, required bone flaps have been reduced to 11 (from ~20). Methods: In a 2-year period (2014-2015), 5 boys with sagittal synostosis underwent MCDO using our simplified and fixed-form osteotomy...
October 2017: Plastic and Reconstructive Surgery. Global Open
Luis Matres-Lorenzo, Aidan McAlinden, Antoine Bernardé, Fabrice Bernard
OBJECTIVE: To describe a new technique to control intraoperative hemorrhage during tibial plateau leveling osteotomy (TPLO) and report subsequent short-term and long-term complications. STUDY DESIGN: Retrospective case series. ANIMALS: Nine dogs with arterial hemorrhage during TPLO. METHODS: Medical records of dogs with hemorrhage controlled through the osteotomy gap of a TPLO were reviewed at 2 institutions over 8 years...
November 16, 2017: Veterinary Surgery: VS
Jonathan M Bekisz, Elise Fryml, Roberto L Flores
This study presents a systematic review of randomized controlled trials (RCTs) in cleft and craniofacial surgery. All studies reporting on RCTs in cleft and craniofacial surgery were identified on PubMed using the search terms "cleft," "velopharyngeal insufficiency," "velopharyngeal dysfunction," "nasoalveolar molding," "gingivoperiosteoplasty," "Pierre Robin sequence," "craniofacial," "craniosynostosis," "craniofacial microsomia," "hemifacial microsomia," "hypertelorism," "Le Fort," "monobloc," "distraction osteogenesis," "Treacher Collins," and "Goldenhar...
October 27, 2017: Journal of Craniofacial Surgery
Enrico Ghizoni, João Paulo Sant Ana Santos de Souza, Cassio Eduardo Raposo-Amaral, Rafael Denadai, Humberto Belém de Aquino, Cesar Augusto Raposo-Amaral, Andrei Fernandes Joaquim, Helder Tedeschi, Luís Fernando Bernardes, André Luiz Jardini
BACKGROUND: Craniosynostosis is a complex disease once it involves deep anatomic perception, and a minor mistake during surgery can be fatal. The objective of this report is to present novel 3-dimensional-printed polyamide craniosynostosis models that can improve the understanding and treatment complex pathologies. METHODS: The software InVesalius was used for segmentation of the anatomy image (from 3 patients between 6 and 9 months old). Afterward, the file was transferred to a 3-dimensional printing system and, with the use of an infrared laser, slices of powder PA 2200 were consecutively added to build a polyamide model of cranial bone...
January 2018: World Neurosurgery
Alessandro Borghi, Will Rodgers, Silvia Schievano, Allan Ponniah, Owase Jeelani, David Dunaway
Treatment of unicoronal craniosynostosis is a surgically challenging problem, due to the involvement of coronal suture and cranial base, with complex asymmetries of the calvarium and orbit. Several techniques for correction have been described, including surgical bony remodeling, early strip craniotomy with orthotic helmet remodeling and distraction. Current distraction devices provide unidirectional forces and have had very limited success. Nitinol is a shape memory alloy that can be programmed to the shape of a patient-specific anatomy by means of thermal treatment...
October 16, 2017: Journal of Craniofacial Surgery
Anne Morice, Giovanna Paternoster, Agnès Ostertag, Syril James, Martine Cohen-Solal, Roman H Khonsari, Eric Arnaud
BACKGROUND: Frontofacial monobloc advancement (FFMBA) creates a communication between the anterior cranial fossa and nasal cavities. To tackle this issue, trans-orbital pericranial pedicled flaps (PF) are routinely performed in our center. This study aimed to assess the post-operative ossification of the anterior skull base and PF following FFMBA, and to identify factors influencing this ossification. METHODS: Measurements of the skull base only (SB) and of the ossified PF together with the SB (SB-OPF) were performed on CT scans at the naso-frontal (NF) and the naso-ethmoïdo-frontal (NEF) junctions...
October 12, 2017: Plastic and Reconstructive Surgery
Q de Kerangal, A Paré, A Joly, N Travers, D Goga, B Laure
INTRODUCTION: Posterior cranial vault distraction is a treatment for intracranial hypertension in certain cases of craniosynostosis and faciocraniosynostosis. It allows the harmonization of the skull back and prevents turricephaly. This study presents the surgical technique. TECHNICAL NOTE: Posterior cranial vault distraction osteogenesis consists of a circular osteotomy of the skull back. Four distractors are placed on the cranial flap without detachment of the dura mater...
October 10, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
Charles Rodriguez-Feo, Julian Winocour, Roberto Ramirez, Marcia Spear, Kevin Kelly
BACKGROUND: Numerous techniques for the surgical management of lambdoidal synostosis have been previously described; however, no best practice technique currently exists. Surgical procedures range from complete posterior calvarial reconstruction to distraction osteogenesis techniques. Our primary purpose is to describe a novel approach to correct unilateral or bilateral lambdoidal synostosis. METHODS: A retrospective review was performed on a single surgeon's experience with craniosynostosis (1994-2014)...
October 2017: Journal of Craniofacial Surgery
Koji Kawamoto, Cheng Chun Wu, Keisuke Imai
BACKGROUND: Conventional fronto-orbital advancement and distraction osteogenesis (DOG) have been used to treat craniosynostosis, both of which are considered effective. During the authors' practice, a phenomenon of frontal hyperostosis has been observed in the patients of craniosynostosis after DOG, which has yet to be reported in the literature. The purpose of this study is trying to identify the factors related to the phenomenon. MATERIALS AND METHODS: From 1997 to 2010, all patients of craniosynostosis undergoing DOG were reviewed...
November 2017: Journal of Craniofacial Surgery
Melissa LoPresti, Edward P Buchanan, Veeral Shah, Caroline M Hadley, Laura A Monson, Sandi Lam
We report a case of surgical management of Crouzon syndrome with multisuture craniosynostosis presenting with increased intracranial pressure (ICP) manifesting with chronic papilledema without ventriculomegaly. A 12-month-old boy had complete resolution of papilledema after posterior cranial vault distraction followed by staged fronto-orbital advancement. Expansion of the cranial vault with posterior distraction osteogenesis posed an elegant treatment, obviating ventriculoperitoneal shunt placement for cerebrospinal fluid (CSF) diversion...
April 2017: Journal of Pediatric Neurosciences
Kristen A Klement, Karri A Adamson, Narges L Horriat, Arlen D Denny
Studies on the treatment of nonsyndromic craniosynostosis demonstrate decreasing morbidity and mortality; however, complication rates still range from 5% to 14%. Here, the authors present their last 10 years' experience treatment of nonsyndromic single suture craniosynostosis. A retrospective review was performed on patients who underwent open surgical treatment of nonsyndromic craniosynostosis over 10 years. Patient characteristics and clinical outcomes were reviewed. Radiological analysis of intracranial volumes was performed using Amira software...
October 2017: Journal of Craniofacial Surgery
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