Orbitofrontal monobloc advancement for Crouzon syndrome |
| |
| Institution: | 1. Service de Chirurgie Maxillo-Faciale et Plastique de la Face Pédiatrique, CHU Clocheville, 37044 Tours Cedex, France;2. Service de Neurochirurgie Pédiatrique, CHU Clocheville, 37044 Tours Cedex, France;3. Faculté de médecine, Université François-Rabelais de Tours, 10, Boulevard Tonnellé, 37032 Tours Cedex, France;1. Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany;2. Department of Orthodontics, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany;3. Institute of Medical Psychology and Medical Sociology, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany;4. Clinic for Child and Adolescent Psychiatry, Johann Wolfgang Goethe-University, Frankfurt, Germany;1. Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, China;2. Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, No 33, Ba-Da-Chu Road, Shi Jing Shan District, Beijing 100144, China;1. Department of Oral & Maxillofacial Surgery, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;2. Institute of Surgical Sciences, Department of Oral & Maxillofacial Surgery, Uppsala University, Uppsala, Sweden;1. Dept. of Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. H.-F. Zeilhofer), University Hospital Basel, Basel, Switzerland;2. Hightech Research Center of Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. H.-F. Zeilhofer), University of Basel, Basel, Switzerland;3. Krankenhaus Reinbek, Dept. of Surgery (Head: Prof. Dr. T. Strate), Hamburg, Germany |
| |
| Abstract: | IntroductionUsually, patients suffering from Crouzon syndrome have synostosis of coronal sutures, exophthalmia, hypertelorism, and hypoplasia of the middle third of face. Sometimes maxillary retrusion is absent, so these patients have class I or II relationship. In these cases, frontofacial monobloc advancement, which is the gold standard, increases the maxillo-mandibular dysmorphia. Therefore we propose orbitofrontal monobloc advancement minus dental arch, without splits of the pterygoid plates.Case reportA 12-year-old girl with Crouzon syndrome had intracranial hypertension, exophthalmia, a middle third retrusion and a class II occlusion. We achieved orbitofrontal monobloc advancement which is frontofacial monobloc advancement minus maxillary dental arch. Four distractors KLS Martin were used. After 20 days of distraction, the final advancement was 10.2 mm for cranial distractors and 10.5 mm at fronto-zygomatic. Distractors were removed after 8 months.DiscussionWe offer patients suffering from Crouzon syndrome with class I or II relationship a change from the classic frontofacial monobloc advancement leaving the maxillary dental arch in place, thus avoiding the worsening of the maxillo-mandibular dysmorphia related to surgery. The idea of associating Le Fort I osteotomy with a frontofacial monobloc advancement or Le Fort III osteotomy has already been described, mainly by Tessier and Obwegeser, however they probably achieved a complete Le Fort I osteotomy while we don't split the pterygoid plates.The patient's morphology and his surgical history determine the choice between Le Fort III and monobloc advancement. Dental occlusion needs to be taken into account for surgical indication. |
| |
| Keywords: | Crouzon disease Frontofacial monobloc osteotomy Le Fort I osteotomy Craniofacial surgery |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
