Distraction vs remodeling surgery for craniosynostosis |
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Authors: | Seong-Woong Kim Kyu-Won Shim Nick Plesnila Yong-Oock Kim Joong-Uhn Choi Dong-Seok Kim |
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Affiliation: | (1) Institute for Surgical Research, Ludwig Maximilian University, Munich, Germany;(2) Brain Korea 21 Project of Medical Science, Institute for Brain Research, College of Medicine, Yonsei University, Seoul, South Korea;(3) Department of Neurosurgery, Brain Korea 21 Project of Medical Science, Institute for Brain Research, College of Medicine, Yonsei University, Seoul, South Korea;(4) Department of Plastic Surgery, College of Medicine, Yonsei University, Seoul, South Korea;(5) Department of Neurosurgery, Yonsei University College of Medicine, 134 Sinchon-dong, Seodaemun-gu, Seoul, 120-752, South Korea |
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Abstract: | Objects We designed several distraction devices and applied these instruments in 14 patients with varying types of craniosynostosis.
The aim of this report is to clarify the advantages and disadvantages of these surgical methods and to discuss current concepts
for the surgical strategy in the treatment of craniosynostosis.
Methods From January 2000 to July 2005, 28 patients with craniosynostosis were retrospectively analyzed. Surgical treatment was performed
on 14 patients using the distraction method with internal distraction devices that we designed, in which 5 patients had plagiocephaly,
3 brachycephaly, and 6 scaphocephaly. All patients underwent preoperative and postoperative evaluations, which included the
patient’s neurological state, and three-dimensional CT.
Results With distraction devices, the time required for the surgery could be shortened almost 3 1/3 h; the bleeding during the surgery
was decreased with reduced requirement of more than 200 ml of blood transfusion as compared with remodeling surgery. Postoperatively
achieved distraction distances varied from 30.0 to 47.5 mm (mean, 42.99 mm). The average increased volume percent of cranium
in distraction surgery group was 20.9% (range, −11.5 to 58.9%) after full distraction.
Conclusion With distraction surgery, satisfactory cranial volume expansion and aesthetically pleasing morphological states were achieved
in all cases, and the efficacy was statistically significantly high as compared with remodeling method. |
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Keywords: | Craniosynostosis Distraction osteogenesis Statistical analysis |
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