title: Three-dimensional computed tomographic evaluation of Le Fort III distraction osteogenesis with an external device in syndromic craniosynostosis.
abstract: There is little anteroposterior growth of the midface in patients with syndromic craniosynostosis who are followed up over time without intervention. A Le Fort III with distraction osteogenesis can be done to correct this. This is a controlled way in which to achieve appreciable stable advancement of the midface without the need for bone grafting, but the vector of the movement is not always predictable. The purpose of this study was to evaluate the 3-dimensional effect of Le Fort III distraction osteogenesis with an external frame. Ten patients (aged 7-19 years) who had the procedure were included in the study. The le Fort III procedure and the placement of the external frame were followed by an activation period and then a 3-month retention period. Computed tomographic (CT) images taken before and after operation were converted and loaded into 3-dimensional image rendering software and compared with the aid of a paired sample t test and a colour-coded qualitative analysis. Comparison of the CT data before and after distraction indicated that the amount of midface advancement was significant. Le Fort III distraction osteogenesis is an effective way to advance the midface. However, the movement during osteogenesis is not always exactly in the intended direction, and a secondary operation is often necessary. Three-dimensional evaluation over a longer period of time is necessary.
authors.affiliation: Department of Orthodontics, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands(f).
authors.forename: M F
authors.initials: MF
authors.lastname: Wery
authors.affiliation: Department of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Department of Orthodontics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
authors.forename: R M
authors.initials: RM
authors.lastname: Nada
authors.affiliation: Department of Plastic and Reconstructive Surgery, Erasmus MC Rotterdam, The Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: van der Meulen
authors.affiliation: Department of Oral Maxillofacial Surgery, Erasmus MC Rotterdam, The Netherlands.
authors.forename: E B
authors.initials: EB
authors.lastname: Wolvius
authors.affiliation: Department of Orthodontics, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands(f). Electronic address: e.ongkosuwito@erasmusmc.nl.
authors.forename: E M
authors.initials: EM
authors.lastname: Ongkosuwito
mesh_terms: D000168:Acrocephalosyndactylia / Q000601:surgery; D000293:Adolescent; D002508:Cephalometry / Q000379:methods; D002648:Child; D003394:Craniofacial Dysostosis / Q000601:surgery; D003398:Craniosynostoses / Q000000981:diagnostic imaging / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D009915:Orbit / Q000601:surgery; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods*; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult; D015050:Zygoma / Q000601:surgery
keywords: Craniosynostosis; Distraction; Le Fort III; Osteogenesis; Syndromic; Three-dimensional