title: [Segmental monobloc osteotomy and bi-directional distraction for the treatment of Crouzon syndrome in an infant].
abstract: OBJECTIVE
  To discuss the segmental monobloc osteotomy and bi-directional distraction for the treatment of Crouzon syndrome in an infant.
  
  
  METHODS
  A 9-month-old female infant underwent monobloc osteotomy through combined intra- and extra-cranial way. The facial skull was divided into frontal, orbital and maxillary segments. The external distractor was used to move the frontal segment, orbital segment and midface forward. The internal distractor was used to move the maxilla downward. The consolidation lasted for 3 months after distraction.
  
  
  RESULTS
  The osteotomy and distraction were successfully completed. The distraction distance reached 18 mm, showing by distractor. The real distraction distance of facial bone was 12 mm, documented by 3-D image. The skull deformity and severe depression of midface improved a lot. The exophthalmos and underbite were corrected. The obstructive sleep apnea also improved markedly. However, the downward movement of maxilla was limited.
  
  
  CONCLUSIONS
  Monobloc osteotomy with external distractor, as well as maxillary distraction, could be used for Crouzon syndrome in infant. It is safe and effective method which can be performed in an early age for Crouzon syndrome with obstructive sleep apnea.
authors.affiliation: Department of Burn & Plastic Surgery, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing 210008, China.
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Shen
authors.forename: Jie
authors.initials: J
authors.lastname: Cui
authors.forename: Jian-Bin
authors.initials: JB
authors.lastname: Chen
authors.forename: Hai-Ni
authors.initials: HN
authors.lastname: Chen
authors.forename: Ji-Jun
authors.initials: JJ
authors.lastname: Zou
authors.forename: Yi
authors.initials: Y
authors.lastname: Ji
mesh_terms: D003394:Craniofacial Dysostosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D019857:Osteogenesis, Distraction / Q000379:methods*; D010027:Osteotomy / Q000379:methods*