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 purpose of this study was to demonstrate the potential advantages of applying distraction osteogenesis techniques to the correction of orbital and midfacial hypoplasia in craniosynostosis syndromes. Fifteen children with various craniosynostosis syndromes underwent Le Fort III advancement assisted by gradual distraction utilizing a pair of internal distraction devices custom-fabricated for each child. The surgical procedure consisted of a Le Fort III osteotomy, implantation of internal devices with initiation of distraction intraoperatively, and an accelerated rate of midfacial advancement over the next 3 to 5 days. Activation of the distraction hardware was accomplished by a percutaneous pin, which was removed at the end of the distraction protocol, allowing the internal devices to fixate the fragment for a minimum of 6 months during the period of consolidation. With follow-up ranging between 3 to 38 months, the average orbital and midfacial advancement was 19.7 mm (range, 12.0–30.0 mm). Proptosis was lessened and facial proportions significantly improved in all patients. Serious complications were not encountered. The modified distraction protocol utilized in this group of patients was aimed at addressing the unique requirements of pediatric craniofacial surgery, and resulted in almost twice the amount of correction previously reported for traditional rigid fixation techniques.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Craniofaciostenosis is often associated with midfacial hypoplasia and has been treated traditionally using Le Fort advancement osteotomies and bone grafts. The surgical procedure requires a prolonged operating time, several osteotomies with a significant blood loss, and wide surgical exposure. According to the principles of bone lengthening, we performed midfacial advancement by bone distraction in 4 patients with midfacial hypoplasia to reduce the operative time and complication rate. In 2 patients with Crouzon's syndrome we performed a Le Fort III osteotomy and placed the distraction device behind the malar eminence and screwed it on the temporal bone bilaterally. In the other 2 children, with Apert's syndrome, we performed frontal advancement and remodeling before placing the device during the same surgery behind the malar bone without any midfacial osteotomy. It appears to us that patients with more severe deformities will need surgical procedures to offer more satisfactory results. In these patients, distraction is an initial therapy to reduce the severity of the deformity, making it possible to effect a better treatment afterward.

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:

A rare congenital defect of the anterior part of the maxillary bone and absence of teeth is presented. We describe a patient with oral-acral syndrome and the treatment of the maxillary retrusion using distraction osteogenesis.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Surgical treatment for glossoptosis-micrognathic association is indicated in the most severe cases. Usually, complications occur. We used mandibular distraction to pull the tongue away from the posterior pharyngeal wall. This procedure, used in 3 patients, was effective.

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:

Radiotherapy of head and neck tumors very often results in impaired healing of craniomaxillofacial bones in the vicinity. Management of radionecrosis of bones after radiotherapy is an important clinical challenge. Bone morphogenetic proteins (BMPs) induce new bone differentiation. The aim of this study is to investigate the potential of BMPs in ameliorating radiation-induced impaired bone repair. Two 3-mm diameter defects were created in the calvaria of rats. The defects were treated with different doses of recombinant human (rh) BMP-2 using collagen type I as a carrier. Irradiation with a single dose of 1,200 rad was performed 2 or 7 days preoperatively. Unirradiated animals served as controls. New bone formation was assessed by quantitation of radiographs of the calvaria and histology on day 21 after surgery. Untreated, unirradiated defects showed a spontaneous osseous regeneration of 90 ± 7% of the defect area within 21 days. Irradiation of the site (1,200 rad 2 days preoperatively) resulted in a profound decrease in the bone fill of the untreated defect (5 ± 2%). Recombinant human BMP-2 in soluble collagen type I carrier delivered to the defect resulted in a significant increase of new bone formation (34 ± 14%, P < 0.01 for 25 μg rhBMP-2; 77 ± 19% for 35 μg rhBMP-2, P < 0.01). Type I collagen carrier alone resulted in only 7 ± 2% healing. In conclusion, radiation-induced impairment of calvarial repair can be overcome by rhBMP-2. Thus, the concept of BMP-2-induced regeneration has potential applications in reconstructive craniomaxillofacial surgery after irradiation.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Irradiated wounds are characterized by a slow healing process. Insulin-like growth factor-1 (IGF-1), a somatomedin C, has been shown in previous studies to stimulate collagen synthesis and bony repair. The purpose of this investigation is to evaluate the potential beneficial effects of recombinant IGF-1 in the healing of critical size calvarial defects in previously irradiated adult male Sprague-Dawley Rats.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID