The versatility of distraction osteogenesis in craniofacial surgery.
The versatility of distraction osteogenesis in craniofacial surgery.
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DOI：
10.1001/archfaci.4.1.8
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发表时间：
2002-01-01
影响因子：
--
通讯作者：
Chowdhury, Khalid
中科院分区：
文献类型：
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作者：
Imola, Mario J;Hamlar, David D;Chowdhury, Khalid
目的：回顾我们使用牵引成骨矫正颅面畸形的初步结果，并确定其相对于传统颅面手术在治疗解剖畸形和功能缺陷中的作用。方法：连续 24 名患者在 34 个月的时间内接受了牵引成骨治疗。使用临床评估记录、照片记录、诊断成像和治疗计划辅助工具，将结果与先前存在的解剖畸形和功能缺陷进行比较。主要结果指标：根据临床和放射学评估、治疗前后功能缺陷的临床状态以及美观改善的客观评级，实现的分心与计划分心。结论：初步结果表明，在矫正面部骨骼畸形方面，效果良好至优秀。 80%的患者。功能结果包括 14 名患者中 13 名的上气道阻塞得到缓解或显着改善，以及所有 5 名先前存在眼球外翻的患者的角膜暴露得到纠正。咬合不正的矫正不太可靠。与牵引装置相关的问题，包括推进机制和固定的故障，是最普遍的并发症。牵引成骨代表了颅面外科的一项令人兴奋的新发展，具有多种潜在的好处，包括微创手术、早期干预的能力，以及通过改善治疗后稳定性来矫正更严重的畸形的潜力。牵引成骨相对于传统技术的确切作用需要持续评估。
OBJECTIVES: To review our preliminary results using distraction osteogenesis for the correction of craniofacial deformities and to determine its role in treating anatomic deformities and functional deficits relative to conventional craniofacial surgery.DESIGN AND SETTING: Retrospective clinical review; tertiary care center.METHODS: Twenty-four consecutive patients were treated with distraction osteogenesis during a 34-month period. Outcomes were compared with preexisting anatomic deformities and functional deficits using records of clinical assessments, photodocumentation, diagnostic imaging, and treatment planning aids.MAIN OUTCOME MEASURES: Distraction achieved vs planned distraction based on clinical and radiographic assessment, clinical status of functional deficits before and after treatment, and objective rating of aesthetic improvement.CONCLUSIONS: Preliminary results demonstrated good-to-excellent outcome in correcting facial skeletal deformity in 80% of patients. Functional outcomes included resolution or significant improvement of upper airway obstruction in 13 of 14 patients and correction of corneal exposure for all 5 patients with preexisting exorbitism. Correction of malocclusion was less reliable. Problems related to the distraction devices, including failure of the advancement mechanism and fixation, were the most prevalent complications. Distraction osteogenesis represents an exciting new development in craniofacial surgery with several potential benefits, including less invasive surgery, the ability for earlier intervention, and the potential for correction of more severe deformities with improved posttreatment stability. The exact role of distraction osteogenesis relative to conventional techniques requires ongoing assessment.