Biomedical subjects

G Swennen

Publications and source records attributed to G Swennen.

9 recordsLinked to original sources

PubMed2002

Midfacial morphology in children with unilateral cleft lip and palate treated by different surgical protocols.

The purpose of this study was to compare cranio-facial, particularly midfacial morphology, in two groups of children with complete unilateral cleft lip and palate (UCLP) treated at two different cleft centres (Hannover. Germany and Brussels, Belgium) following different surgical treatment protocols. A total of 62 children (40 males; 22 females) with non-syndromic UCLP were included in this study at approximately the age of 10. The Hannover group comprised 36 children, who had repair of the lip at a mean age of 5.83 +/- 1.16 months, followed by repair of the hard and soft palate at a mean age of 29.08 +/- 4.68 and 32.25 +/- 4.29 months. respectively. The Brussels group consisted of 26 children who underwent surgical treatment according to the Malek protocol: the soft palate was closed at a mean age of 3.04 +/- 0.20 months, followed by simultaneous repair of the lip and hard palate at a mean age of 6.15 +/- 0.68 months. Midfacial morphology was evaluated by means of cephalometric analysis according to Ross. The children in the Hannover UCLP group did not differ significantly from those in the Brussels group in the anteroposterior dimension of the midface. However, the maxillary plane was significantly more open in the Brussels group due to less posterior vertical maxillary development.

Age Factors↗

PubMed2002

Cranio-facial distraction osteogenesis: a review of the literature. Part II: Experimental studies.

In this study the literature dealing with experimental cranio-facial distraction osteogenesis (DO) was reviewed. A PUBMED search (National Library of Medicine [NCBI] revised 1 April 2001) from 1966 through December 2000 was conducted. Key words used in the search were: distraction, lengthening, mandible, mandibular, maxilla, maxillary, midface, midfacial, monobloc, cranial, cranio-facial, maxillofacial. This search revealed a total of 120 experiment-orientated articles that were all analyzed in detail in this study. The purpose of the experimental study, animal model, animal growth status, type of distraction, type of surgery, distraction rate and rhythm, latency and contention period, amount of lengthening, relapse, complications and nature of the distraction device were analyzed. This review revealed that a total of 1207 animals were used in seven different animal models for research on cranio-facial DO: 54 using dogs (45.0%), 25 using rabbits (20.8%), 18 using sheep (15.0%), 11 using minipig (9.2%), seven using monkeys (5.8%), four using rats (3.3%) and one using a cat model (0.8%). Based on the results of this study, an attempt was made to provide biological DO parameters and guidelines for future research on experimental cranio-facial DO related to the appropriate animal model.

Animals↗

PubMed2002

[Bone distraction osteogenesis].

Bone osteogenesis has been used by many surgeons to compensate dissymmetry due to congenital malformations, diseases or traumas. Bone distraction is the process of generating new bone in a gap between two bone segments in response to the application of graduated tensile stress across the bone gap. Different types of distraction are actually proposed to be an alternative to facial osteotomies or bone grafting techniques. Distraction can be unilateral, bilateral and correct the deficiencies in one, two or three dimensions. The advantages of the distraction osteogenesis are the possibilities to obtain bone lengthening together with simultaneous expansion of the functional soft tissue matrix including skin, muscles, nerves, cartilage, blood vessels and periosteum. Distractors are internal or external devices made of pins or miniplates fixed on the bone and connected by lengthening--screw--systems allowing elongation.

Adolescent↗

PubMed2001

Craniofacial distraction osteogenesis: a review of the literature: Part 1: clinical studies.

A review of the literature dealing with distraction osteogenesis (DO) of the craniofacial skeleton, provided by a PUBMED search (National Library of Medicine, NCBI; revised 3 April 2000) from 1966 to December 1999 was conducted. Key words used in the search were distraction, lengthening, mandible, mandibular, maxilla, maxillary, midface, midfacial, monobloc, cranial, craniofacial and maxillofacial. This search revealed 285 articles. One hundred and nine articles were clinically orientated and were analysed in detail in this study. The type of distraction, indications, age, type of surgery, distraction rates and rhythms, latency and contention periods, amount of lengthening, follow-up period, relapse, complications and the nature of the distraction device were analysed. This review revealed that 828 patients underwent DO of the craniofacial skeleton; 579 underwent mandibular DO, 129 maxillary DO, 24 simultaneous mandibular and maxillary DO and 96 midfacial and/or cranial DO. Craniofacial DO has proven to be a major advance for the treatment of numerous congenital and acquired craniofacial deformities. Treatment protocols and success criteria for craniofacial DO are suggested on the basis of these results. There is still, however, a lack of sufficient data, especially on follow-up and relapse, so that treatment strategies have to be validated by long-term studies in the future.

Adolescent↗

PubMed2001

Melanotic neuroectodermal tumor of infancy involving the mandible: 7-year follow-up after hemimandibulectomy and costochondral graft reconstruction.

Oral and maxillofacial tumors occur rarely in the pediatric population compared with the adult population. We report a case of a 6-months old female infant suffering from a melanotic neuroectodermal tumor of infancy involving the mandible. Tumor resection was performed using a submandibular approach; the mandibular defect was reconstructed primarily with autogenous costochondral grafts. During a 7-year follow-up period, there has been no tumor recurrence. The costochondral graft healed well; tracing of panoramic radiographs at 2, 3, and 6 years documented some vertical overgrowth and growth retardation in the transversal dimension. The authors conclude that the use of costochondral grafts despite its controversial role for mandibular reconstruction can be recommended in particular after continuity resections in newborn infants. However, long-term follow-up is necessary as well as secondary corrective surgery at early skeletal maturity.

Bone Transplantation↗

PubMed2000

Maxillary distraction osteogenesis: a method with skeletal anchorage.

Maxillary distraction osteogenesis is a challenging technique to treat severe maxillary retrusion. Maxillary advancement by distraction has the advantage to provide new bone in combination with simultaneous expansion of the soft-tissue functional matrix. Cleft lip and palate patients can present with severe maxillary retrusion and Class III malocclusion. Two 13-year-old patients, born with non-syndromic cleft lip and palate, underwent maxillary distraction--one had a bilateral, the other a unilateral complete cleft lip and palate. Maxillary advancement was performed using an external distraction device in combination with titanium miniplates as a skeletal maxillary anchorage. After a complete Lefort I osteotomy with pterygomaxillary disjunction, a latency period of 3 days was respected. On the fourth postoperative day, distraction was initiated at the rate of 1 mm/d. Preoperative clinical photographs, dental casts, lateral cephalograms, and panoramic radiographs were taken. Further lateral cephalograms were obtained after the latency period, after completion of the active period of distraction, at the completion of the consolidation period, and at 6 and 12 months postoperatively. The aesthetic outcome was excellent and skeletal advancement of 8 and 7 mm was measured without dentoalveolar compensations.

Adolescent↗

PubMed2000

Maxillary distraction osteogenesis: a two-dimensional mathematical model.

Patients with cleft lip and palate with severe maxillary retrusion usually have a mandible with anterior-superior autorotation and subsequent overclosure and loss of the vertical facial dimension. Maxillary distraction osteogenesis can correct the sagittal maxillomandibular relationship and should simultaneously reestablish vertical dimension through maxillary vertical height increase and clockwise rotation of the mandible to restore facial balance. We present a two-dimensional mathematical model in the sagittal plane, which reestablishes sagittal and vertical skeletal deficiencies and proper occlusal alignment for planning maxillary advancement with distraction osteogenesis in patients with cleft lip and palate. The model is illustrated in a case of a 13-year-old boy with a complete bilateral cleft lip and palate and severe maxillary retrusion. The two-dimensional mathematical model described in this article allows the surgeon and orthodontist to calculate in a simple and accurate way the ideal distraction vector to advance the maxilla to its desired position.

Adolescent↗

PubMed1999

Maxillary distraction in cleft lip palate patients: a review of six cases.

Cleft lip and palate patients can present with a maxillary retrusion with tendency to Class III malocclusion after cleft repair. Maxillary distraction osteogenesis is a technique that provides simultaneous skeletal advancement and expansion of the soft tissues. Six nonsyndromic cleft lip and palate patients, ages 12 to 16 years (mean, 13.8 years), underwent maxillary distraction; four had a unilateral and two a bilateral cleft lip and palate. After an incomplete LeFort I osteotomy; a latency period of 3 days was respected. On Postoperative Day 4, distraction was initiated through anterior traction on a Delaire facial mask using distraction forces of 900 gm. Photographs and lateral cephalometric radiographs were obtained preoperatively and 4 months after distraction. A cephalometric analysis was performed to compare the sagittal dentocraniofacial morphology before and after distraction. The aesthetic improvement obtained by maxillary distraction osteogenesis during the permanent dentition to correct maxillary retrusion in our cleft lip and palate patients was impressive. Skeletal advancement varying from 1 to 3.5 mm (mean, 1.7 mm) was found. However, significant dentoalveolar compensations occurred in three patients. This was due to the dental anchorage of the distraction device and can be avoided only by the use of skeletal fixation.

Adolescent↗

PubMed1999

Neuro-ophthalmic complication after maxillary surgery.

We report an unusual case of ophthalmoplegia after maxillofacial surgery. A thirteen year old girl with unilateral left cleft lip and palate underwent maxillary advancement by distraction osteogenesis. Postoperatively she developed diplopia. The diplopia was not due to orbital lesions, most often seen after maxillofacial surgery, but to a haemorrhage posterior to the cavernous sinus.

Adolescent↗