摘要:

The use of three-dimensional, computer-generated anatomic models can be used in the diagnosis and reconstruction of a variety of craniofacial problems. They are readily manufactured from computed to mography scans at a reasonable cost with only several weeks of preparation and delivery time. Their contemporary value is in the preoperative treatment planning, intraoperative implant fashioning, and preoperative implant fabrication in appropriately selected patients.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The purpose of this study was to determine the effectiveness of intrauterine reconstruction of lateral facial clefts caused by surgically simulated amniotic band compression. The authors hypothesized that intrauterine lysis of these bands could: 1) prevent the progression of cleft formation; 2) normalize facial development; and 3) allow for the scarless repair of these lateral atypical facial clefts. In a prospective randomized trial, eight 65-day gestational fetal lambs (term, 140 days) were exposed via a maternal hysterotomy. A Tessier 7 facial cleft was made by applying a 2.0 nylon suture as a constriction band to the growing face. The sutures were attached to the zygomatic arch and looped circumferentially into the oral commissure. Two weeks after surgery, four of eight animals were reexposed. All four animals developed phenotypic changes consistent with Tessier 7 lateral facial clefts. These animals were treated in utero by 1) excising the synthetic constricting band, and 2) opening the epithelialized edges of the lateral facial clefts and performing a primary repair. At birth, the bands on the four untreated animals were cut. The lambs developed to 3 months of age, at which time they were evaluated anthropomorphically for changes in soft tissue measurements, and histologically using hematoxylin and eosin and Mason trichrome stain for the degree of scar at the repair site. Tessier 7 lateral facial clefts were produced in all the untreated animals. Each developed macrostomia with an average 2.3-cm lateral displacement of the oral commissure and partial maxillary clefting induced by the pressure of the restriction band. No evidence of tissue necrosis, maceration, or ulceration was noted. In contrast, animals treated in utero were phenotypically normal. There was no evidence of macrostomia and all anthropomorphic measurements were symmetrical. No bony clefts were seen on gross examination. Histologically, there was no evidence of scar formation at the site of the cleft repair. These findings suggest that like the standard cleft lip, atypical lateral facial clefts can be repaired successfully in utero without scarring. Furthermore, lysis of a restriction band in utero can prevent the progression of this facial deformity, leading to normal development of the face.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The application of distraction osteogenesis in craniomaxillofacial surgery has created new treatment methods for patients with craniofacial skeletal dysplasias. Most of the applications in the craniofacial skeleton have been for the correction of severe congenital or acquired conditions. As more understanding is gained with these new approaches, refinements in techniques will enhance treatment planning and outcome. This will expand the application of distraction osteogenesis to more common, less severe types of skeletal dysplasias. One of the important areas in mandibular distraction osteogenesis is the management of the dental gap created when distraction is applied within the tooth-bearing segment of the mandibular body. In this study, the authors investigated the effects of orthodontic tooth movement into new bone created through the process of distraction osteogenesis. Orthodontic tooth movement through newly formed mandibular bone in the canine model was performed and, through histologic studies, was found to create compact bone along the path of the moving tooth. This compact bone replaced the more unstructured woven bone that was originally created by the process of mandibular distraction osteogenesis. These findings indicate that orthodontic tooth movement can be performed in distracted bone and can have significant influence on the stability and long-term structural preservation of the bone created by distraction osteogenesis within the tooth-bearing segment of the mandible.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

On February 20–23, 1997 in Scotsdale, Arizona, a symposium was held that was sponsored by the Plastic Surgery Educational Foundation, the American Society of Maxillofacial Surgeons, and the Joint Section on Pediatric Neurological Surgery of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. The chairs of the meeting were Jeffrey C. Posnick and Harold L. Rekate. The symposium examined issues relating to craniosynostosis and skull molding. The program consisted of three parts. Day 1 focused on the basic concepts of craniosynostosis and skull molding. Day 2 focused on evaluation and treatment of craniosynostosis. Day 3 focused on the diagnosis and treatment of craniofacial syndromes. The symposium was significant because it brought craniofacial and pediatric neurosurgeons together for the first time at a combined meeting to discuss important aspects of craniosynostosis and skull molding. This article summarizes the presentations made at the meeting.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID