title: Appropriate indication of fronto-orbital advancement by distraction osteogenesis in syndromic craniosynostosis: Beyond the conventional technique.
abstract: Currently the distraction technique could be very useful for posterior expansion in syndromic craniosynostosis. Even for fronto-orbital advancement (FOA), it is thought that distraction has the definitive advantage over the conventional technique. The authors describe the appropriate indication of distraction for FOA in our series of craniosynostosis patients. Since 1998, FOA by distraction has been used for 61 cases of simple and syndromic craniosynostosis. Among these, seven severe cases were extracted with a conspicuous craniofacial deformity with a multiple honeycomb appearance in 3DCT views. Early surgery for FOA by distraction to the extent possible was performed and a retrospective study was conducted. Seven children were identified. All of them exhibited a severe craniofacial deformity. Pfeiffer syndrome in 5 children and clover-leaf skull in two unidentified children were diagnosed. Mean age at surgery for FOA by distraction ranged 10-18 months. Mean operative time: 3-3.5 h. Blood loss: 230-320 mL. The mean advancement by distraction: 20-27 mm. We conclude FOA by distraction when a large amount of advancement is required for early severe cases as our series can be definitely one of the most appropriate candidates beyond the conventional technique, despite disadvantages.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan. Electronic address: kane.satoh@faculty.chiba-u.jp.
authors.forename: Kaneshige
authors.initials: K
authors.lastname: Satoh
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Mitsukawa
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kubota
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan.
authors.forename: Shinsuku
authors.initials: S
authors.lastname: Akita
mesh_terms: D000168:Acrocephalosyndactylia / Q000601:surgery*; D002648:Child; D003398:Craniosynostoses / Q000601:surgery*; D006801:Humans; D019857:Osteogenesis, Distraction / Q000379:methods*; D012189:Retrospective Studies; D013577:Syndrome
keywords: Distraction osteogenesis; Fronto-orbital advancement; Syndromic craniosynostosis