title: Comparing calvarial transport distraction with and without radiation and fat grafting.
abstract: The purpose of this study is to: a) assess transport distraction to reconstruct cranial defects in radiated and non-radiated fields b) examine adipose grafting's effect on the bony regenerate and overlying wound, and c) elucidate sources of bone formation during transport distraction osteogenesis. Twenty-three male New Zealand white rabbits (3 months; 3.5 kg) were used, 10 non-irradiated and 13 irradiated (17 treatment, 6 control) with a one-time fraction of 35 Gy. A 16 × 16 mm defect was abutted by a 10 × 16 mm transport disc 5 weeks after irradiation, and 11 animals were fat grafted at the distraction site. Latency (1 day), distraction (1.5 mm/day), and consolidation (4 weeks) followed. Fluorochromes were injected subcutaneously and microCT, fluorescence, and histology assessed. In distracted animals without fat grafting, bone density measured 701.87 mgHA/ccm and 2271.95 mgHA/ccm in irradiated and non-irradiated animals. In distracted animals with fat grafting, bone density measured 703.23 mgHA/ccm and 2254.27 mgHA/ccm in irradiated and non-irradiated animals. Fluorescence revealed ossification emanating from the dura, periosteum, and transport segment with decreased formation in irradiated animals. Transport distraction is possible for cranial reconstruction in irradiated fields but short-term osseous fill is significantly diminished. Adipose grafting enhances wound healing in previously irradiated fields but does not enhance ossification.
authors.affiliation: Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States.
authors.forename: Mikell M
authors.initials: MM
authors.lastname: Yuhasz
authors.affiliation: Oral and Maxillofacial Surgery, University Medical Centre Mainz & Research Fellow Plastic Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States.
authors.forename: Felix P
authors.initials: FP
authors.lastname: Koch
authors.affiliation: Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States.
authors.forename: Anna
authors.initials: A
authors.lastname: Kwiatkowski
authors.affiliation: Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States.
authors.forename: Calvin
authors.initials: C
authors.lastname: Young
authors.affiliation: Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States.
authors.forename: James
authors.initials: J
authors.lastname: Clune
authors.affiliation: Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States.
authors.forename: Rob
authors.initials: R
authors.lastname: Travieso
authors.affiliation: Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wong
authors.affiliation: Yale Core Center for Musculoskeletal Disorders, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States.
authors.forename: Joshua
authors.initials: J
authors.lastname: Van Houten
authors.affiliation: Section of Plastic & Reconstructive Surgery, Director of Craniofacial Program, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States. Electronic address: derek.steinbacher@yale.edu.
authors.forename: Derek M
authors.initials: DM
authors.lastname: Steinbacher
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000818:Animals; D015519:Bone Density / Q000502:physiology / Q000528:radiation effects; D001847:Bone Diseases / Q000532:radiotherapy / Q000601:surgery*; D001861:Bone Regeneration / Q000502:physiology / Q000528:radiation effects; D016723:Bone Remodeling / Q000502:physiology / Q000528:radiation effects; D004388:Dura Mater / Q000473:pathology / Q000528:radiation effects; D005456:Fluorescent Dyes; D008297:Male; D010012:Osteogenesis / Q000502:physiology / Q000528:radiation effects; D019857:Osteogenesis, Distraction / Q000379:methods*; D010521:Periosteum / Q000473:pathology / Q000528:radiation effects; D011817:Rabbits; D011879:Radiotherapy Dosage; D011897:Random Allocation; D019651:Plastic Surgery Procedures / Q000379:methods*; D012535:Scalp / Q000473:pathology / Q000528:radiation effects; D012886:Skull / Q000528:radiation effects / Q000601:surgery*; D013524:Surgical Flaps / Q000601:surgery; D014945:Wound Healing / Q000502:physiology / Q000528:radiation effects; D055114:X-Ray Microtomography / Q000379:methods
chemical_list: D005456:Fluorescent Dyes
keywords: 3D distraction; Bone distraction; Calvaria; Skull reconstruction