Monobloc distraction osteogenesis during infancy: report of a case and presentation of a new device.
Monobloc distraction osteogenesis during infancy: report of a case and presentation of a new device.
复制标题
婴儿期整体牵引成骨：病例报告和新装置介绍。
DOI：
10.1097/00006534-199806000-00022
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发表时间：
1998
影响因子：
3.6
通讯作者：
R. Hudgins
中科院分区：
文献类型：
--
作者：
S. R. Cohen;W. Boydston;F. Burstein;R. Hudgins
下颌骨牵引成骨的临床应用已被证明是治疗先天性下颌畸形的一项重大进展。在各种临床情况下，牵引成骨治疗上颌骨和面中部发育不良的可行性已经被几位作者证明。在动物模型中使用弹簧式装置进行颅底扩张。1992年，Remmler等人提出了用颅骨导向装置成功地扩张兔的颅顶和面中部。Rachmiel等人在Jackson的实验室工作，在横向放置的销上安装了加长螺栓，用于成年绵羊面中部的牵拉。Staffenberg等人在犬体内放置了改良的Hoffman骨延长器，报告了未成熟的无骨质骨的犬面中部偏斜。1994年，我们报道了临床上首次尝试对半面部矮小症患者进行面中部牵张，使用了一个腭部扩张螺丝钉焊接到Vitalium板上。通过头影测量和计算机断层扫描记录了单侧上颌骨垂直和矢状面的延长。在过去的三年里，我们与莱宾格-豪美迪达的工程师密切合作，开发了一种低调的埋藏式设备，能够由外科医生在手术室的手术台上定制。遵循的基本原则是：L)广泛而稳定地附着在下层骨上；2)术中修改的能力；3)提供多方向牵张。在此，我们报告了我们最新的原型用于Pfeiffer综合征的9个月大的女孩的颅骨、眼眶和面中部的牵张成骨。
The clinical application of distraction osteogenesis to the mandible has proven to be a major advance in the treatment of congenital mandibular deformities. The feasibility of distraction osteogenesis to treat maxillary and midfacial hypoplasia in a variety of clinical situations has been demonstrated by several authors."* Experimentally, Persing et al." used a spring-type device for skull-base expansion in an animal model. Successful expansion of the cranial vault and midface with a craniotactic device in rabbits was presented by Remmler et al..." in 1992. Rachmiel et al.," working in Jackson's laboratory, mounted lengthening bolts on transversely placed pins for midfacial dis-traction in adult sheep. Staffenberg et al." placed a modified Hoffman bone-lengthening device in canines, reporting midface distrac-tion in the immature canine without osteoto-mies. In 1994, we reported one of the first clinical attempts of midface distraction in a patient with hemifacial microsomia, employing a palatal expansion screw soldered to Vitallium plates." Unilateral vertical and sagittal lengthening of the maxilla was documented by cephalometry and computed tomography scans. During the past 3 years we have worked closely with engineers at Leibinger-Howmedica to develop a low-profile, buried device capable of customization on the operating room table by the surgeon. The basic principles adhered to are: l) a broad and stable attachment to the underlying bone; 2) the ability for intraoperative modification; and 3) the provision for multidirectional distraction. Herein we report the use of our latest prototype for distraction osteogenesis of the cranium, orbits, and midface in a 9-month-old girl with Pfeiffer syndrome.