Simultaneous multiple vector distraction for craniosynostosis syndromes

• Published in: British journal of plastic surgery Vol. 58; no. 5; pp. 626 - 631
• Main Authors: Anderson, Peter J., Tan, Eugene, David, David J.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.07.2005; Elsevier
• Subjects: Acrocephalosyndactylia - diagnostic imaging; Acrocephalosyndactylia - surgery; Adolescent; Apert syndrome; Biological and medical sciences; Child; Complex syndromes; Craniosynostoses - diagnostic imaging; Craniosynostoses - surgery; Diseases of the osteoarticular system; Distraction osteogenesis; External Fixators; Facies; Female; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Male; Malformations and congenital and or hereditary diseases involving bones. Joint deformations; Maxillofacial surgery. Dental surgery. Orthodontics; Medical genetics; Medical sciences; Osteogenesis, Distraction - methods; Osteotomy; Osteotomy - methods; Osteotomy, Le Fort - methods; Pfeiffer syndrome; Radiography; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Pfeiffer syndrome; Apert syndrome; Osteotomy; Distraction osteogenesis; Nervous system diseases; Multiple; Craniosynostosis; Diseases of the osteoarticular system; Lower limb; Dysostosis; Congenital disease; Treatment; Malformation; Surgery; Skull disease; Distraction; Upper limb; Vector
• ISSN: 0007-1226; 1465-3087
• DOI: 10.1016/j.bjps.2004.12.029

Syndromic craniosynostoses are commonly treated conditions in craniofacial units. The features of the common syndromes (Apert, Pfeiffer and Crouzon) all include craniosynostosis, mid-face hypoplasia and ocular proptosis. The craniofacial management of a child with these syndromes through to adulthood may require a number of surgical interventions to allow brain development, to provide an adequate airway, to prevent corneal ulceration and to provide a functional dental occlusion. The management of these different priorities into timed interventions in our unit is determined by established protocols. We report two cases that underwent simultaneous mid-face (Le Fort III) and fronto-orbital osteotomies followed by distraction but using different vectors to advance the upper and mid-face regions (to achieve all treatment goals) in a 12-year-old boy and a 16-year-old girl.