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Soft-Tissue Volumetric Changes Following Monobloc Distraction Procedure: Analysis Using Digital Three-Dimensional Photogrammetry System (3dMD).
MedLine Citation:
PMID:  23524705     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
We have previously reported that monobloc advancement by distraction osteogenesis resulted in decreased morbidity and greater advancement with less relapse compared with acute monobloc advancement with bone grafting. In this study, we examine the three-dimensional (3D) volumetric soft-tissue changes in monobloc distraction.Patients with syndromic craniosynostosis who underwent monobloc distraction from 2002 to 2010 at University of California-Los Angeles Craniofacial Center were studied (n = 12). We recorded diagnosis, indications for the surgery, and volumetric changes for skeletal and soft-tissue midface structures (preoperative/postoperative [6 weeks]/follow-up [>1 year]). Computed tomography scans and a digital 3D photogrammetry system were used for image analysis.Patients ranged from 6 to 14 years of age (mean, 10.1 years) at the time of the operation (follow-up 2-11 years); mean distraction advancement was 19.4 mm (range, 14-25 mm). There was a mean increase in the 3D volumetric soft-tissue changes: 99.5 ± 4.0 cm (P < 0.05) at 6 weeks and 94.9 ± 3.6 cm (P < 0.05) at 1-year follow-up. When comparing soft-tissue changes at 6 weeks postoperative to 1-year follow-up, there were minimal relapse changes. The overall mean 3D skeletal change was 108.9 ± 4.2 cm. For every 1 cm of skeletal gain, there was 0.78 cm of soft-tissue gain.Monobloc advancement by distraction osteogenesis using internal devices resulted in increased volumetric soft-tissue changes, which remained stable at 1 year. The positive linear correlation between soft-tissue increments and bony advancement can be incorporated during the planning of osteotomies to achieve optimum surgical outcomes with monobloc distraction.
Authors:
Fuan Chiang Chan; Henry K Kawamoto; Christina Federico; James P Bradley
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of craniofacial surgery     Volume:  24     ISSN:  1536-3732     ISO Abbreviation:  J Craniofac Surg     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010410     Medline TA:  J Craniofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  416-20     Citation Subset:  D    
Affiliation:
From the University of California-Los Angeles Department of Plastic and Reconstructive Surgery, David Geffen School of Medicine, Los Angeles, California.
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