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Biomedical subjects

B H Grayson

Publications and source records attributed to B H Grayson.

12 recordsLinked to original sources
PubMed1992

Lengthening the human mandible by gradual distraction.

Lengthening of the mandible by gradual distraction was performed on four young patients (average age 78 months). The amount of mandibular bone lengthening ranged from 18 to 24 mm; one patient with Nager's syndrome underwent bilateral mandibular expansion. Following the period of expansion, the patients were maintained in external fixation for an average of 9 weeks to allow ossification. The patients were followed for a minimum of 11 months to a maximum of 20 months with clinical and dental examinations as well as photographic and radiographic documentation. The technique holds promise for early reconstruction of craniofacial skeletal defects without the need for bone grafts, blood transfusion, or intermaxillary fixation.

Bone Lengthening↗
PubMed1990

The Le Fort III advancement osteotomy in the child under 7 years of age.

This is a longitudinal study of 12 patients with craniofacial synostosis syndromes (Crouzon's, Apert's, Pfeiffer's) who underwent Le Fort III advancement under the age of 7 years (average age 5.1 years, range 4.0 to 6.7 years). The average follow-up was 5.0 years and included clinical, dental, and cephalometric examinations according to a prescribed protocol. The study demonstrated that the procedure could be safely performed in the younger child with an acceptable level of morbidity. There was a remarkable degree of postoperative stability of the maxillary segment. However, although vertical (inferior) growth or movement of the midfacial segment was demonstrated, there was minimal, if any, anterior or horizontal growth. Any occlusal disharmony developing during the period of follow-up could be attributed to anticipated mandibular development and could be corrected by orthognathic surgery. The roles of surgical overcorrection and anterior-pull headgear therapy after release of intermaxillary fixation are also discussed. The Le Fort III osteotomy is justifiably indicated during early childhood for psychological and physiologic reasons.

Acrocephalosyndactylia↗
PubMed1989

Cephalometric analysis for the surgeon.

A protocol for cephalometric analysis is presented to enable the clinician to evaluate the craniofacial skeleton for surgery. Cephalometric tracing and analysis are described and applied to a clinical case. The three-dimensional cephalometric method and analysis are discussed for application in planning the correction of craniofacial asymmetry.

Adult↗
PubMed1987

Mean tensor cephalometric analysis of a patient population with clefts of the palate and lip.

This study was designed to elucidate the net "effect" of primary and secondary palatal clefts on the craniofacial skeleton as viewed in the lateral cephalogram. A tensor cephalometric analysis is reported for 144 patients with cleft lip, cleft palate, or both. The study involves 13 lateral landmarks located in the patients' cephalograms and in the Michigan normative means. The net deformity (total sample) is a reduction of size in all directions, but primarily in the horizontal dimension (ANS-PNS) at the palatal level. Lower face height is affected less than upper face height. The bilateral group shows a considerably greater amount of "net" deformity in the cranial base and reduction in mandibular body length. The effect of cleft of the secondary palate alone is horizontal. The effect of an additional primary cleft is aligned instead vertically in the maxilla and intensifies the reduction of cranial base depth. These findings concur with the literature that attributes these syndromes to different mechanisms with different modes of inheritance.

Adolescent↗
PubMed1986

The mandible in mandibulofacial dysostosis: a cephalometric study.

The lower border of the mandible in mandibulofacial dysostosis is characteristic of the syndrome. Evaluation of the cephalograms by means of the medial axis analysis and inflectional tangents captures the shape deformity. Morphometric data from lateral cephalograms on seven patients, ages 3 through 20 years, are reported: a total of 22 observations on three males and four females. These forms were compared to normal mandibular forms from the University of Michigan University School Study. The curvature of the gonial angle in the study population is not distinguishable from the normal curvature. Relative to this apparently normal region, there is a marked downward displacement of the symphysis that results in the curvature typical of the lower mandibular border in this syndrome. These findings are not consistent with earlier reports.

Adolescent↗
PubMed1985

Basilar multiplane cephalometric analysis.

This article presents a method of cephalometric tracing and analysis using the basilar view cephalogram and discusses its role in diagnosis and treatment planning. Landmarks and structures found in each of three separate basilar planes are defined and instructions for tracings are presented. The analysis is applied to the study of orbital hypertelorism, craniofacial synostosis, and hemicraniofacial microsomia. The multiplane tracing technique is demonstrated to provide a three-dimensional concept of deformities in the craniofacial skeleton. A method to determine an anteroposterior midline construct from structures in the cranial base is described. As is practiced with the lateral cephalogram, presurgical tracings of the basilar film may be manipulated to simulate the skeletal changes anticipated in surgery.

Cephalometry↗
PubMed1985

A comparative cephalometric study of the cranial base in craniofacial anomalies: Part I: Tensor analysis.

The method of mean tensor analysis was used to study the cranial base in six craniofacial anomalies: Crouzon's disease, Apert's syndrome, Pfeiffer's syndrome, craniofacial microsomia (CFM), Treacher Collins (TC) syndrome, and frontonasal dysplasia (FND). The form was represented by five landmarks: the nasion (N), basion (Ba), sella (S), frontomaxillonasal suture (FMN), and sphenoethmoidal registration point (SE), and the deformities were computed as mean deformations from age- and sex-matched normal mean forms. The cranial base in CFM is normal in shape. The other five syndromes manifest four distinct patterns of shape variation. Only in TC and Pfeiffer's syndrome is the cranial-base angle distinctive. In Apert's and Crouzon's syndromes, point SE is displaced anteriorly upon a cranial base, small in size but otherwise normal in shape. In TC syndrome and FND, point SE is displaced posteriorly toward the sella.

Acrocephalosyndactylia↗