Kobayashi Shinji, Fukawa Toshihiko, Hirakawa Takashi, Maegawa Jiro
Department of Plastic and Reconstructive Surgery, Knagawa Children's Medical Center, Yokohama, Kanagawa, Japan; Fukawa Orthodontic Clinic, Ofuna, Kanagawa, Japan; Hirakawa Orthodontic Clinic, Yokohama, Kanagawa, Japan; and Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan.
Plast Reconstr Surg Glob Open. 2014 Mar 6;2(2):e113. doi: 10.1097/GOX.0000000000000060. eCollection 2014 Feb.
We have developed a hybrid facial osteogenesis distraction system that combines the advantages of external and internal distraction devices to enable control of both the distraction distance and vector. However, when the advanced maxilla has excessive clockwise rotation and shifts more downward vertically than planned, it might be impossible to pull it up to correct it. We invented devices attached to external distraction systems that can control the vertical vector of distraction to resolve this problem. The purpose of this article is to describe the result of utilizing the distraction system for syndromic craniosynostosis.
In addition to a previously reported hybrid facial distraction system, the devices for controlling the vertical direction of the advanced maxilla were attached to the external distraction device. The vertical direction of the advanced maxilla can be controlled by adjustment of the spindle units. This system was used for 2 patients with Crouzon and Apert syndrome.
The system enabled control of the vertical distance, with no complications during the procedures. As a result, the maxilla could be advanced into the planned position including overcorrection without excessive clockwise rotation of distraction.
Our system can alter the cases and bring them into the planned position, by controlling the vertical vector of distraction. We believe that this system might be effective in infants with syndromic craniosynostosis as it involves 2 osteotomies and horizontal and vertical direction of elongation can be controlled.
我们开发了一种混合式面部骨生成牵张系统，该系统结合了外部和内部牵张装置的优点，能够控制牵张距离和矢量。然而，当晚期上颌骨出现过度顺时针旋转且垂直向下移位超过预期时，可能无法将其上拉以进行纠正。我们发明了一种附着于外部牵张系统的装置，可控制牵张的垂直矢量以解决此问题。本文的目的是描述利用该牵张系统治疗综合征性颅缝早闭的结果。
除了先前报道的混合式面部牵张系统外，用于控制晚期上颌骨垂直方向的装置被附着于外部牵张装置上。晚期上颌骨的垂直方向可通过调整主轴单元来控制。该系统用于2例患有克鲁宗综合征和阿佩尔综合征的患者。
该系统能够控制垂直距离，手术过程中无并发症。结果，上颌骨能够被推进到计划位置，包括过度矫正，而不会出现牵张过度顺时针旋转。
我们的系统可以通过控制牵张的垂直矢量来改变病例并使其达到计划位置。我们认为该系统可能对患有综合征性颅缝早闭的婴儿有效，因为它涉及两次截骨术，并且可以控制水平和垂直方向的伸长。
