Department of Orthodontics and Oral Biology, Radboud University Nijmegen Medical Centre, The Netherlands.
J Craniomaxillofac Surg. 2010 Mar;38(2):83-9. doi: 10.1016/j.jcms.2009.03.014. Epub 2009 May 17.
Aim of the study was to get more insight into the opinion of European surgeons and orthodontists on the use of distraction osteogenesis (DO) for patients with different diagnoses and treatment protocols. A web based survey was set up, showing records of four patients with different conditions: hemifacial microsomia (case 1), bilateral mandibular deficiency (case 2), cleft lip and palate (case 3) and Crouzon syndrome (case 4). Respondents from 181 Eurocleft centres were asked to fill out a questionnaire for each patient. Most of the respondents considered case 1 (80%), case 3 (81%) and case 4 (86%) suitable for DO, while only 31% were considering case 2 for DO. There was lack of consensus among the respondents about many aspects of DO. Out of six different treatment parameters, an acceptable degree of agreement was only seen in two: a latency period of 3-7 days and a distraction rate of 1mm per day. Furthermore, there was noticeable disagreement on the ideal age for treatment, surgical technique, distraction device, and retention period. Our results showed that there is a wide variety in treatment approaches for craniofacial anomalies in Europe. There is disagreement on essential steps in the distraction procedures.
研究目的是更深入地了解欧洲外科医生和正畸医生对使用牵引成骨术（DO）治疗不同诊断和治疗方案患者的看法。我们建立了一个基于网络的调查，展示了四位不同患者的病例记录：单侧颜面短小症（病例 1）、双侧下颌骨发育不全（病例 2）、唇腭裂（病例 3）和颅缝早闭症（病例 4）。来自 181 个 Eurocleft 中心的受访者被要求为每位患者填写一份问卷。大多数受访者认为病例 1（80%）、病例 3（81%）和病例 4（86%）适合使用 DO，但只有 31%的受访者考虑对病例 2 使用 DO。对于 DO 的许多方面，受访者之间缺乏共识。在六个不同的治疗参数中，只有两个方面的一致性程度可以接受：潜伏期为 3-7 天，每天牵引 1mm。此外，对于治疗的理想年龄、手术技术、牵引装置和保持时间等方面存在明显的分歧。我们的结果表明，欧洲对颅面畸形的治疗方法多种多样，在牵引手术的关键步骤上存在分歧。
