Rattan Vidya, Sharma Ramesh Kumar, Gupta Akshat, Singh Satinder Pal, Singh Apoorva, Jolly Satnam Singh
104, Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research Chandigarh, Chandigarh, 160012 India.
Plastic and Reconstructive Surgery, Post Graduate Institute of Medical Education and Research Chandigarh, Chandigarh, 160012 India.
J Maxillofac Oral Surg. 2024 Dec;23(6):1355-1365. doi: 10.1007/s12663-024-02202-8. Epub 2024 May 24.
Syndromic craniosynostosis is characterized by premature fusion of cranial sutures resulting in midface deficiency. Lefort III Distraction Osteogenesis (DO) has emerged as an effective surgical intervention for addressing this complex condition. This case series outlines the outcomes, encountered difficulties, and insights gained through the utilization of Lefort III Distraction Osteogenesis (DO). Six patients (age range: 8-18 years) diagnosed with syndromic craniosynostosis underwent Lefort III DO for midface deficiency correction.
Comprehensive preoperative orthodontic preparation and meticulous surgical planning were executed. The present paper highlighted the promising outcomes with Lefort III DO, such as significant advancements in midface projection, enhanced posterior pharyngeal space, improved ocular position, and the establishment of functional occlusion.
However, some complications such as CSF blepharocele, pin-tract infection, cranial pin perforation, and loosening of the halo frame were encountered. These challenges were addressed with prompt intervention and close postoperative monitoring. Lefort III DO emerges as a valuable approach in effectively addressing midface deficiency in syndromic craniosynostosis patients. While yielding favorable outcomes in terms of facial aesthetics and function, it requires meticulous surgical technique and vigilant postoperative care to address potential complications.
This paper contributes insights into the effective management and potential challenges associated with Lefort III DO in treating midface deficiency in syndromic craniosynostosis patients.
综合征性颅缝早闭的特征是颅骨缝线过早融合,导致面中部发育不全。勒福III型牵引成骨术(DO)已成为治疗这种复杂病症的一种有效手术干预方法。本病例系列概述了通过应用勒福III型牵引成骨术(DO)所取得的结果、遇到的困难以及获得的见解。6例(年龄范围:8至18岁)被诊断为综合征性颅缝早闭的患者接受了勒福III型牵引成骨术以矫正面中部发育不全。
进行了全面的术前正畸准备和细致的手术规划。本文强调了勒福III型牵引成骨术的良好效果,如面中部突出显著改善、咽后间隙增大、眼位改善以及功能性咬合的建立。
然而,遇到了一些并发症,如脑脊液眼睑膨出、针道感染、颅骨针穿孔和头环松动。通过及时干预和密切的术后监测解决了这些问题。勒福III型牵引成骨术成为有效解决综合征性颅缝早闭患者面中部发育不全的一种有价值的方法。虽然在面部美学和功能方面产生了良好效果,但需要精湛的手术技术和警惕的术后护理来应对潜在并发症。
本文为勒福III型牵引成骨术治疗综合征性颅缝早闭患者面中部发育不全的有效管理及潜在挑战提供了见解。