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Muscles for Facial Expressions

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The craniofacial muscles are a collection of approximately 20 thin skeletal muscles situated beneath the skin of the face and scalp. These muscles, primarily responsible for the vast array of human facial expressions, originate from the bones or fibrous structures of the skull and extend outwards to connect with the skin. While most skeletal muscles in the body are enveloped in thick fascia, facial muscles generally have a more delicate fascial covering, with the buccinator muscle being a...

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Updated: Nov 4, 2025

A Mouse Distraction Osteogenesis Model

A Mouse Distraction Osteogenesis Model

Published on: November 14, 2018

Counterclockwise Craniofacial Distraction Osteogenesis.

Richard A Hopper¹, Howard D Wang¹, Ezgi Mercan²

¹The Craniofacial Center, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA; Division of Plastic Surgery, Department of Surgery, University of Washington.

Clinics in Plastic Surgery

|May 30, 2021

Summary

This summary is machine-generated.

Counterclockwise craniofacial distraction osteogenesis successfully expands airway volume in Treacher Collins syndrome and bilateral craniofacial microsomia patients. This surgical technique can lead to successful decannulation, improving breathing for affected individuals.

Keywords:

Craniofacial microsomia Distraction osteogenesis Hemifacial microsomia Mandibular distraction Midface distraction Midface hypoplasia Treacher Collins syndrome Upper airway obstruction

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Area of Science:

Craniofacial surgery
Pediatric plastic surgery
Otolaryngology

Background:

Treacher Collins syndrome and bilateral craniofacial microsomia cause multilevel airway obstruction due to maxillomandibular hypoplasia and rotation.
Affected patients often require tracheostomy despite multiple prior surgical interventions.
Current treatments have limited success in fully resolving airway obstruction.

Purpose of the Study:

To evaluate the efficacy of counterclockwise craniofacial distraction osteogenesis in correcting facial skeletal deformities.
To assess the impact of this procedure on upper airway volume expansion.
To determine the potential for decannulation in patients with severe airway obstruction.

Main Methods:

Counterclockwise craniofacial distraction osteogenesis was performed, rotating the subcranial complex en bloc around the nasofrontal junction.
Pre- and post-operative airway volumes were measured using advanced imaging techniques.
Patient outcomes, including decannulation rates, were documented.

Main Results:

The procedure resulted in significant increases in nasopharyngeal and oropharyngeal airway volumes.
A majority of patients who underwent the operation were successfully decannulated.
Facial skeletal deformities were effectively corrected, improving facial aesthetics.

Conclusions:

Counterclockwise craniofacial distraction osteogenesis is a promising surgical approach for managing airway obstruction in Treacher Collins syndrome and bilateral craniofacial microsomia.
This technique offers a viable solution for patients previously refractory to other treatments.
Successful decannulation demonstrates the procedure's effectiveness in improving respiratory function.