title: Craniofacial distractor applicator.
abstract: Craniofacial distraction can be planned using cephalograms, computed tomography, medical models, and other forms of anatomic data. However, it is often difficult to translate this plan to the patient. Specifically, it is difficult to obtain true parallel placement of bilateral midface and mandibular distractors. Intraoperative translation of preoperatively determined vectors is also troublesome. One method of application uses computed tomography data with radiofrequency triangulation technology in a specially equipped room. This helps with the issue of placement on the patient but does not establish parallelism. We have developed a simple-to-use craniofacial application stabilization device that allows equal placement of bilateral distractors and measurement of distraction vectors. The applicator measures 20 cm in length in its open configuration. The terminal portion of the device has a coupler that holds the distractor during placement. The device is hinged in 3 points so that it can be easily folded into a compact and autoclavable device (7 x 3 cm). The hinges allow equal placement of bilateral distractors. Each hinge can be calibrated to determine the vector of distraction and confirm equal application. Lastly, the stabilizer can be fixed to nasion with a Steinmann pin for reference, allowing intraoperative translation of distraction vectors. We demonstrated on skull models that the craniofacial distractor applicator can accurately allow parallel intraoperative placement of craniofacial distractors. We demonstrated simultaneous placement of the distractors allowing a more precise determination of end points.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of California, San Francisco, California 94143, USA. david.dorfman@ucsf.edu
authors.forename: David W
authors.initials: DW
authors.lastname: Dorfman
authors.forename: Frank S
authors.initials: FS
authors.lastname: Ciminello
authors.forename: Granger B
authors.initials: GB
authors.lastname: Wong
mesh_terms: D002138:Calibration; D004867:Equipment Design; D016267:External Fixators; D005147:Facial Bones / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D010027:Osteotomy / Q000295:instrumentation; D010347:Patient Care Planning; D012886:Skull / Q000601:surgery*