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At least 379 records · Page 21Linked to original sources
PubMed2000

An in vitro study of the accuracy of a new protocol for planning distraction osteogenesis of the mandible.

PURPOSE: The purpose of this study was to determine the in vitro accuracy of a new protocol for distraction osteogenesis of the mandible that involves a planning process and a surgical technique. MATERIALS AND METHODS: An experimental design was developed to simulate distraction osteogenesis on stereolithographic models of patients with craniofacial deformities. All patients had previously undergone 3-dimensional computerized scans of the craniofacial skeleton. The data from these scans were used to generate stereolithographic models. Before the fabrication of the models, the computed tomography (CT) data were manipulated to add a series of rulers and markers to the models. The 3-dimensional computerized scans were also used as the basis of the planning process. They were imported into an animation software (3D-Studio Max; Discreet, Montreal, Canada), and a virtual distractor was built and installed on the model, and the osteotomies and distraction processes were simulated. Finally, a recipe for sequencing the linear and angular changes of the distractor were calculated. A surgical technique was developed to facilitate the precise installation of the distractor as indicated in the presurgical plan. The transfer of information regarding pin position and orientation from the computer model to the patient was accomplished by creating a surgical template. This template was designed in the computer and fabricated by use of stereolithography. Mock surgery was performed on the stereolithographic models, and the results were compared with those predicted by the computer. The difference between the actual position and the predicted position was recorded. RESULTS: On the X-axis, the difference between the predicted position for the condylar marker and the actual position of the marker on the stereolithographic models was 0.6 +/- 1.1 mm. On the Y-axis, the difference between the predicted position for the condylar marker and the actual position of the marker on the stereolithographic models was -0.9 +/- 2.6. On the Z-axis, the difference between the predicted position for the condylar marker and the actual position of the marker on the stereolithographic models was 0.04 +/- 0.8 mm. There was excellent correlation between the predicted and the actual measurements for the X, Y, and Z axes: 0.98, 0.93, and 0.98, respectively. CONCLUSIONS: The results indicate that the combination of this planning process and surgical technique was very accurate. This in vitro study is the first step in determining the clinical usefulness of this protocol. If the results of this study are validated in clinical practice, this protocol will allow clinicians to improve the clinical outcomes of patients treated with distraction osteogenesis.

Analysis of Variance↗
PubMed1987

[Craniofacial surgery].

A craniofacial team is functioning since 15 years in Sophia's Children Hospital and Dijkzigt Hospital. An intensive-care unit and a anaesthesist specialised in children is imperative for proper functioning of the team. An overview of the most common Craniofacial malformation is given, the operative technique of craniosynostosis described and the complications discussed.

Cleft Lip↗
PubMed2000

Three-dimensional spiral CT of craniofacial malformations in children.

OBJECTIVE: To assess the value of three-dimensional CT (3D CT) in the diagnosis and management of suspected paediatric craniofacial malformations. MATERIALS AND METHODS: Twenty-eight children (12 girls, 16 boys) with a mean age of 4 years, suffering from craniofacial or cervical malformations, underwent craniofacial spiral CT. 3D reformatting was performed using an independent work-station. RESULTS: 3D CT allowed the preoperative evaluation of 16 patients with craniosynostosis and the post-surgical management of 2 patients. 3D CT clearly depicted malformations of the skull base involving the petrous bone in seven patients (four cases of Goldenhar-Gorlin syndrome, one case of Treacher-Collins syndrome and two cases of Crouzon's disease). Four patients with craniofacial clefts were also evaluated. Radiological findings were confirmed by the clinical and intraoperative findings in all patients that underwent surgical treatment. Movement artefacts and "Lego effect" related to abrupt change of cranial vault border were encountered and are discussed. CONCLUSIONS: 3D CT of the skull can safely and reliably identify paediatric craniofacial malformations involving bone, and it should be used as morphological mapping to help the surgeon in planning surgical treatment.

Adolescent↗
PubMed1986

Three-dimensional CT reformation in children.

Three-dimensional computed tomographic (CT) reformation has proven useful in the evaluation of congenital malformations of the brain as well as in the surgical approach and postoperative assessment of craniofacial anomalies in children. This technique was performed on 41 patients, of whom eight are presented. The congenital anomalies of semilobar holoprosencephaly and colpocephaly are described. Six representative cases of craniofacial anomalies with pre- and postoperative examinations include Crouzon syndrome, orbital fibrous dysplasia, frontonasal encephalocele, cranial involvement from neurofibromatosis, Treacher-Collins syndrome, and a Tessier III facial cleft. Addition of the dimension of depth provides a view heretofore not obtainable by standard imaging techniques and allows more accurate diagnosis as well as a more specific approach to surgical planning and follow-up.

Brain↗