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 consistent pattern of craniosynostosis in the sagittal and bilateral lambdoid sutures is described in three patients. The external cranial ridging associated with fusion of these sutures produces a characteristic triradiate, or “Mercedes Benz,” appearance to the posterior skull. Locally marked growth restriction is evident in the posterior fossa with compensatory secondary expansion of the anterior fossa manifesting a degree of frontal bossing which mimics bicoronal synostosis. Although this appearance could lead to inadvertent surgery in the frontal region, attention to the occipital region with wide early suture excision and vault shaping is indicated.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The requirements for reconstruction in patients with midface hypoplasia can be formidable: a bicoronal scalp incision, Le Fort III or monobloc skeletal advancement, harvesting and insertion of bone grafts, application of rigid (and occasionally intermaxillary) fixation, blood transfusions, and prolonged operative time and hospitalization. The introduction of the endoscope offers the possibility of minimally invasive surgery with improved visualization of the osteotomy sites. The development of distraction osteogenesis as a surgical technique allows controlled and gradual advancement of the osteotomized skeletal segment and associated soft tissue. The purpose of this study was to develop a canine model of an endoscopically assisted Le Fort III osteotomy with attendant midface distraction. Four mongrels (20 kg in weight) were study subjects. Three 2-cm skin incisions were made (two perpendicular to the zygomaticomaxillary suture and one perpendicular to the nasofrontal suture). The soft tissue and periosteum were evaluated bluntly. Retractors specially designed for the project created a space for endoscopic visualization. Bilateral zygomatic, nasofrontal, and medial orbital wall osteotomies, corticotomies, or both were performed under endoscopic visualization using a reciprocating saw; the medial orbital wall sectioning was specifically not completed (i.e., corticotomy) to avoid laceration of the mucosa and attendant bleeding. The pterygomaxillary osteotomy was completed with an osteotome and mallet. Finally, the nasal septum was only partially divided with an osteotome to avoid excessive blood loss. Four distraction devices were placed across the above-noted osteotomies (two across the nasofrontal osteotomy and one across each lateral osteotomy). The animals were distracted 1 mm per day for 16 to 40 days after surgery (16–40 mm of linear distraction). Cephalograms and computed tomography scans were obtained before and after distraction. The animals were killed after remaining in fixation for 4 to 6 weeks after distraction. All soft tissue was removed and the skull was examined. Photos were obtained throughout the experiment for documentation. The study demonstrated that Le Fort III osteotomies can be performed successfully via small incisions with endoscopic assistance in canine subjects with excellent visualization and minimal bleeding. The advancement of the midface segment can be achieved by activation of an external distraction device.

ISSN:1049-2275    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Fibrous dysplasia is a rare disease, the cause of which in not entirely known. The most common clinical manifestations of fibrous dysplasia of the temporal bone are the presence of two different pathologic disorders: morphologic and functional. In this study, a rare complication of fibrous dysplasia with temporal localization is examined, and includes a description of a clinical case considered by the authors to be emblematic both for the rarity of the area involved and for the peculiarity of the initial manifestations.

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

摘要:

The purpose of this study was to evaluate the surgical outcomes of the 1.5-mm LactoSorb plating system (Walter Lorenz Surgical, Inc., Jacksonville, FL, U. S. A.) used to stabilize the osteotomized calvarial bone in pediatric patients who have undergone craniofacial surgery. The records of 33 consecutive pediatric patients who underwent craniofacial surgery from January 1997 through December 1997 were reviewed. There were 18 male and 15 female patients, and the age ranged from 4 months to 12 years. Patients were followed-up at 1 week, 1 month, 3 months, 6 months, and 12 months after surgery. For those patients reviewed, the following information is included: age, sex, diagnosis, surgical procedures, number and size of LactoSorb plates and screws used in each patient, operative difficulty of the screws and the heat pack, and postoperative complications, including wound healing, palpability, and infection. The LactoSorb plating system was used to stabilize the osteotomized calvarial bones in 33 patients who were diagnosed with: 1) craniosynostosis, 2) hydrocephalus, 3) fibrous dysplasia, or 4) cranial deformation. Orbital rim advancement and anterior cranial vault reshaping were performed in 17 patients. Posterior cranial vault reshaping, orbital rim advancement, and anterior cranial vault reshaping were performed in eight patients. Posterior cranial vault reshaping only was performed in seven patients. Excision of fibrous dysplasia from temporal bone was performed in one patient. One patient had a postoperative wound infection, and LactoSorb plates were palpable postoperatively in four patients. The LactoSorb plating system provided adequate rigidity for stabilizing the osteotomized calvarial bone during surgery and maintained adequate rigidity after surgery during the bone healing period before absorption. This plating system showed satisfactory results in pediatric craniofacial surgery patients.

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