Craniofacial bone an experimental study on craniofaicial disttaction osteogenesis

牵张成骨的颅骨成形术近年来得到了广泛的关注。然而，这种新方法能否取代传统方法仍存在争议。为了证实其有效性和安全性，我们进行了兔颅骨牵张成骨的实验研究。（成骨研究）头颅取软x线照片，采用NIH图像计算成骨面积。牵张后2周、4周、8周，成骨面积分别占骨缺损面积的38%、42%、62%。单纯牵引后未见成骨区。软x线检查后，对标本进行脱钙处理，并制作一系列4-μm矢状切片。光镜组织学检查显示牵张后4周牵张间隙编织骨和成骨细胞，提示膜内骨化。牵张8周后出现更先进的成骨和从编织骨到板层骨的转变。软骨样体也发育了，表明所谓的反软骨样骨形成。这些发现使我们得出结论，牵张成骨颅骨成形术促进成骨，减少颅骨骨缺损的形成。（脑损伤研究）光镜组织学检查显示硬脑膜未因牵张而破裂，并与颅骨保持连接。硬膜外腔未见脓肿形成或积血。脑部损伤也未被发现。这些发现表明，普通的头颅分散对大脑或硬脑膜没有伤害

Cranioplasty performed with distraction osteogenesis has gained much attention these days. It, however, still is controversial whether this novel method could supersede conventional method. To substantiate its usefulness and safety, we conducted an experimental study on calvarial distraction osteogenesis in rabbits.(STUDY ON OSTEOGENESIS) After decapitation, soft X-ray photograph was taken and the osteogenesis area was calculated using NIH image. The osteogenesis area was revealed to occupy 38%, 42%, and 62% of the bone defect area, 2weeks, 4weeks, and 8weeks after distraction, respectively. No osteogenesis area was demonstrated just after distraction. Following soft X-ray examination, the specimens were decalcified and serial 4-μm saggital sections were prepared. Histlogical examination using light microscope demonstrated woven bone and osteoblast at the distraction space 4weeks after distraction, suggesting intramembranous ossification. More advanced osteogenesis and the transition from woven bone to lamellar bone were demonstrated 8weeks after distraction. Chondroid was also developed, indicating so-called trans-chondroid bone formation. These findings led us to conclude that cranioplasty with distraction osteogenesis promote osteogenesis and reduce calvarial bone defect formation.(STUDY ON BRAIN DAMAGE) Histological examination using light microscope demonstarated that the dura mater had not been ruptured by distraction and was kept attached to the calvarial bone. There was no abscess formation or blood accumulation at the epidural space. Brain injury was not detected either. These findings suggested that ordinary calvarial distraction do no harm to the brain or the dura mater