Shen Wei-Min, Cui Jie, Chen Jian-Bin, Chen Hai-Ni, Zou Ji-Jun, Ji Yi
Department of Burn & Plastic Surgery, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing 210008, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2011 Sep;27(5):327-31.
To discuss the segmental monobloc osteotomy and bi-directional distraction for the treatment of Crouzon syndrome in an infant.
A 9-month-old female infant underwent monobloc osteotomy through combined intra- and extra-cranial way. The facial skull was divided into frontal, orbital and maxillary segments. The external distractor was used to move the frontal segment, orbital segment and midface forward. The internal distractor was used to move the maxilla downward. The consolidation lasted for 3 months after distraction.
The osteotomy and distraction were successfully completed. The distraction distance reached 18 mm, showing by distractor. The real distraction distance of facial bone was 12 mm, documented by 3-D image. The skull deformity and severe depression of midface improved a lot. The exophthalmos and underbite were corrected. The obstructive sleep apnea also improved markedly. However, the downward movement of maxilla was limited.
Monobloc osteotomy with external distractor, as well as maxillary distraction, could be used for Crouzon syndrome in infant. It is safe and effective method which can be performed in an early age for Crouzon syndrome with obstructive sleep apnea.
探讨节段性整块截骨术及双向牵引术治疗婴儿克鲁宗综合征的疗效。
对一名9个月大的女婴采用颅内联合颅外整块截骨术。面颅骨被分为额部、眶部和上颌部节段。使用外部牵引器向前移动额部节段、眶部节段和中面部。使用内部牵引器向下移动上颌骨。牵引后巩固期持续3个月。
截骨术和牵引术成功完成。牵引器显示牵引距离达18 mm。三维图像记录面骨实际牵引距离为12 mm。颅骨畸形和中面部严重凹陷明显改善。眼球突出和下颌前突得到矫正。阻塞性睡眠呼吸暂停也明显改善。然而，上颌骨向下移动受限。
外部牵引器整块截骨术及上颌骨牵引术可用于婴儿克鲁宗综合征的治疗。这是一种安全有效的方法，可在早期用于伴有阻塞性睡眠呼吸暂停的克鲁宗综合征。
