Plastic Surgery Research Council
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CRANIAL DISTRACTION OSTEOGENESIS ON SYNDROMIC CRANIOSYNOSTOSIS: LONG-TERM FOLLOW-UP AND EFFECT ON POSTOPERATIVE CRANIAL GROWTH
Presenter: Kazuaki Yamaguchi, MD
Co-Authors: Imai KI; Fujimoto TF; Takahashi MT; Maruyama YM
Osaka city general hospital

Background: Although cranial distraction osteogenesis (CDO) is beneficial, few studies have reported on detailed operative procedures and postoperative cranial growth. Herein, we demonstrated the objective effectiveness of CDO in younger infants.

Methods: The study included infants who underwent primary cranial distraction for craniosynostosis. Infants who had hydrocephalus were excluded and those who underwent additional osteotomy surgeries were analyzed before the subsequent procedures. The infants computed tomography data were analyzed using MimicsĆ software (Materialise, Leuven, Belgium) to calculate the cranial volumes and compare them with the Abbott curve for a normal population. We defined cranial growth gap (CGG) as the difference between the subject data and normal infant data to demonstrate the perioperative effects on cranial growth.

Results: CDO was performed in 10 infants. The mean infant age at the time of surgery was 6.4 months (range, 24 61 months) and the mean duration of postoperative follow-up was 38.9 months (range, 24 61 months). Five infants with Crouzon syndrome and five with Apert s syndrome were included. All infants showed postoperative cranial growth, but CGG showed postoperative declines for a certain period, indicating cranial growth suppression immediately following expansion. At the last follow-up, all cases were within ± 2 SD compared with the normal population. Using the declining CGG curve, we derived a formula to predict the CDO target volume.

Conclusions: CDO was applicable and suitable for younger infants requiring aggressive cranial expansion.


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