Midface distraction osteogenesis using a modified external device and 3D virtual simulation: technical note
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TECHNICAL NOTE
Midface distraction osteogenesis using a modified external device and 3D virtual simulation: technical note Ricardo Santos de Oliveira 1 & Matheus Fernando Manzolli Ballestero 1,2 & Marcelo Volpon Santos 3 & Paulo Barrero Marques Marques Netto 4 & Guilherme Gozzoli Podolsky Gondim 1 & Fernando Melhem Elias 5 Received: 26 March 2020 / Accepted: 5 June 2020 / Published online: 25 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction/Background Distraction osteogenesis (DO) with an external distraction device such as the rigid external distraction frame has become an established method for treating midface hypoplasia in faciocraniosynostosis. It allows for greater advancement of the midface in comparison with traditional Le Fort III osteotomies, associated or not with fronto-orbital osteotomies (Le Fort IV). However, the forward movement of the bone segments may not always be performed obeying an ideal distraction vector, resulting in asymmetries, anterior open bite, and loosening of screws. In addition, the cost of the distraction devices is significant and may preclude their routine use in developing countries. Method We present an alternative device and method for craniofacial advancement in a clinical case of Crouzon’s syndrome. Results A 3D virtual simulation of the distraction vector and a modified external device were used in the current case. Conclusion The alternative external device in this case proved to be safe, effective, and reliable. Keywords Crouzon’s syndrome . Distraction osteogenesis . Le fort III osteotomy . Midface hypoplasia . Rigid external device . 3D surgery simulation
Introduction Distraction osteogenesis (DO) is an effective treatment modality widely used for the correction of skeletal congenital defects. The Ricardo Santos de Oliveira and Matheus Fernando Manzolli Ballestero contributed equally to this work. * Ricardo Santos de Oliveira [email protected] 1
Division of Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
2
Department of Medicine, Federal University of São Carlos, São Carlos, Brazil
3
Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
4
Department of Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil
5
Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil
goal is based on the concept of generating newly formed bone by progressive stretching of divided segments [1]. The utilization of DO in children is mainly for treating craniofacial deformities, especially in syndromic craniosynostoses such as Crouzon, Apert, and Pfeiffer syndromes, among others [2]. The establishment of a correct diagnosis and treatment plan is one of the most critical parts in the ma
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