Nakajima Hideo, Sakamoto Yoshiaki, Tamada Ikkei, Ohara Hirotoshi, Kishi Kazuo
Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan.
J Craniofac Surg. 2011 Jul;22(4):1240-6. doi: 10.1097/SCS.0b013e31821c0fef.
There are no procedures available to reconstruct the normal cranial shape irrespective of the type of cranial deformity with minimal patient stress and morbidity. To achieve dynamic total skull remodeling, we considered a new remodeling concept and developed a new procedure by combining morcellation craniotomy and distraction osteogenesis, termed the MoD procedure, and designed a distraction device, namely the angle variable distraction (AVD) system. Between 2000 and 2009, we treated 41 patients with craniosynostosis (28 and 13 cases of isolated and syndromic craniosynostosis, respectively) by using the MoD procedure with the AVD system. Compared with the conventional methods, the mean operative time was significantly shorter, and the mean transfusion volume was significantly less for the MoD procedure. In all the patients, good cranial shape and adequate cranial volume were achieved without serious complications. In conclusion, the MoD procedure with the AVD system is safe, effective, and reliable for dynamic total skull remodeling with minimal morbidity. It could be used to improve the previous surgical concepts for treating craniosynostosis.
无论颅骨畸形的类型如何，目前都没有能够在最小化患者压力和发病率的情况下重建正常颅骨形状的手术方法。为了实现动态全颅骨重塑，我们考虑了一种新的重塑概念，并通过结合碎骨开颅术和牵张成骨技术开发了一种新的手术方法，称为MoD手术，并设计了一种牵张装置，即角度可变牵张（AVD）系统。在2000年至2009年期间，我们使用带有AVD系统的MoD手术治疗了41例颅缝早闭患者（分别为28例孤立性和13例综合征性颅缝早闭）。与传统方法相比，MoD手术的平均手术时间显著缩短，平均输血量显著减少。在所有患者中，均实现了良好的颅骨形状和足够的颅骨容积，且无严重并发症。总之，带有AVD系统的MoD手术对于动态全颅骨重塑是安全、有效且可靠的，发病率极低。它可用于改进先前治疗颅缝早闭的手术概念。
