The Directive Growth Approach for Nonsyndromic, Unicoronal Craniosynostosis: Patient and Clinical Outcomes
| Autor: | Michael E. Burton, John W. Polley, John A. Girotto, Robert J. Mann, Matthew P Fahrenkopf |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Unicoronal craniosynostosis Statistical difference 030230 surgery Audiology Cranial synostosis 03 medical and health sciences Craniosynostoses 0302 clinical medicine Growth restriction Clinical Studies Outcome Assessment Health Care Medicine Humans In patient directive growth Retrospective Studies business.industry Skull Infant General Medicine Cranial Sutures Synostosis medicine.disease Surgery Osteotomy frontal orbital advancement craniosynostosis medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis Coronal plane Forehead Female business Tomography X-Ray Computed Coronal Follow-Up Studies |
| Zdroj: | The Journal of Craniofacial Surgery |
| ISSN: | 1536-3732 1049-2275 |
| Popis: | Deformities of the cranium in patients with nonsyndromic single-suture synostosis occur because of growth restriction at fused sutures and growth over compensation at normal sutures. Traditional surgery includes ostectomies of the synostotic suture to release these restricted areas and osteotomies to enable immediate cranial remodeling. In the process of reshaping the cranium, traditional approaches usually involve obliteration of both the normal functioning suture and the pathologic suture. The directive growth approach (DGA) is a new, simpler, more natural way to repair deformities caused by single-suture cranial synostosis. The DGA works by reversing the original deforming forces by temporarily restricting growth in areas of over compensation and forcing growth in areas of previous synostotic restriction. Most importantly, it preserves a normal functioning suture to allow for improved future cranial growth. Eighteen consecutive nonsyndromic patients with unilateral coronal synostosis were used to illustrate the efficacy of the DGA. Ten patients who underwent DGA treatment were compared with a control group of 8 patients treated with traditional frontal orbital advancement. Postoperative three-dimensional computed tomography (CT) comparison measurements were taken, including bilateral vertical and transverse orbital dimensions, lateral orbital rim to external auditory canal, and forehead measurements from the superior aspect of the orbital rim to the pituitary fossa. The traditional treatment group showed absence of the coronal sutures bilaterally on long-term CT scans. The DGA group showed normal coronal sutures on the unaffected sides. Postoperative CT measurements showed no statistical difference between the 2 techniques (P |
| Databáze: | OpenAIRE |
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