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A Mouse Distraction Osteogenesis Model
Published on: November 14, 2018
Functional outcomes in monobloc advancement by distraction using the rigid external distractor device
Helen Witherow1, David Dunaway, Robert Evans
1London, United Kingdom From the Department of Craniofacial Surgery, Great Ormond Street Hospital, and the Thames Regional Cleft Service.
Plastic and Reconstructive Surgery
|March 20, 2008
Summary
Monobloc distraction osteogenesis effectively advances the midface in patients with craniofacial dysostosis, improving function and appearance. However, complications necessitate technique refinement for safer outcomes.
Area of Science:
- Craniofacial surgery
- Orthognathic surgery
- Pediatric plastic surgery
Background:
- Craniofacial dysostosis syndromes cause multisutural synostoses and severe midfacial retrusion.
- Functional issues include airway obstruction, ocular exposure, visual pathway dysfunction, and increased intracranial pressure.
- Early midface advancement is crucial, with distraction osteogenesis offering significant safe advancements.
Purpose of the Study:
- To evaluate the functional and aesthetic outcomes of monobloc advancement osteotomies using rigid external distractors in patients with craniofacial dysostosis.
- To assess the multidisciplinary management and complication rates associated with this procedure.
Main Methods:
- Retrospective study of 20 patients with craniofacial dysostosis and severe midface hypoplasia.
- Monobloc advancement osteotomies performed using a rigid external distractor system.
- Recording of multidisciplinary management and outcome measures.
Main Results:
- Average midface distraction of 16.4 mm (range 12–22 mm).
- Successful ocular protection, improved visual pathway function, and improved airway obstruction in relevant patients.
- Functional improvements in hyponasality and speech; decannulation in 5/7 tracheostomy patients.
- Complications included CSF leakage, hypernasality, bone loss, and sinus formation requiring revision.
Conclusions:
- Monobloc distraction osteogenesis yields favorable aesthetic and functional results for craniofacial dysostosis.
- A significant complication rate necessitates further technical adaptations to minimize procedural risks.
