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Distraction Osteogenesis Versus Conventional Fronto-Orbital Advancement for the Treatment of Unilateral Coronal Synostosis: A Comparison of Perioperative Morbidity and Short-Term Outcomes

Tahiri, Youssef ; Swanson, Jordan W ; Taylor, Jesse A

The Journal of craniofacial surgery, 2015-09, Vol.26 (6), p.1904-1908 [Periódico revisado por pares]

United States

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Título:
Distraction Osteogenesis Versus Conventional Fronto-Orbital Advancement for the Treatment of Unilateral Coronal Synostosis: A Comparison of Perioperative Morbidity and Short-Term Outcomes
Autor: Tahiri, Youssef ; Swanson, Jordan W ; Taylor, Jesse A
Assuntos: Blood Loss, Surgical ; Blood Transfusion - statistics & numerical data ; Cephalometry - methods ; Craniosynostoses - surgery ; Craniotomy - methods ; Critical Care - statistics & numerical data ; Dentistry ; Esthetics ; Female ; Follow-Up Studies ; Frontal Bone - surgery ; Humans ; Infant ; Length of Stay - statistics & numerical data ; Male ; Operative Time ; Orbit - surgery ; Osteogenesis, Distraction - methods ; Postoperative Complications ; Prospective Studies ; Reconstructive Surgical Procedures - methods ; Strabismus - etiology ; Treatment Outcome
É parte de: The Journal of craniofacial surgery, 2015-09, Vol.26 (6), p.1904-1908
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: Fronto-orbital advancement and remodeling (FOAR) remains the most widely practiced treatment of unicoronal craniosynostosis (UCS) despite recent studies of ocular dysfunction and aesthetic shortcomings in the long-term. The aim of the study was to compare perioperative morbidity and short-term outcomes of a recently developed, nondevascularizing, distraction-based treatment of UCS with conventional FOAR. To do so, the authors compared the first 6 patients who were treated with a new osteotomy/distraction approach to the last 6 patients who underwent traditional FOAR for the treatment of UCS with regards to demographics, operative details, perioperative morbidity, and short-term outcomes.Between July 2012 and June 2014, 6 patients underwent each procedure. Duration of surgery and length of hospital stay in the distraction group were on average 2 hours 7 minutes and 3.4 days, respectively, significantly less than in the traditional FOAR group (P = 0.039, P = 0.032, respectively). Perioperative blood loss averaged 169 mL, which trended toward less than in the traditional group (mean of 400 mL, P = 0.065). Patients undergoing conventional compared with distraction osteogenesis-mediated FOAR were significantly more likely to develop new-onset strabismus postoperatively (odds ratio 15.4; P = 0.0384). All 12 patients completed therapy without complications and with Whitaker grade I results at latest follow-up.In the perioperative period, distraction-mediated cranial vault remodeling provides similar correction of the aesthetic deformity associated with UCS and an improved morbidity profile. Longer follow-up is needed to determine how distraction compares with FOAR with respect to neuropsychologic and long-term aesthetic outcomes.
Editor: United States
Idioma: Inglês

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Distraction Osteogenesis Versus Conventional Fronto-Orbital Advancement for the Treatment of Unilateral Coronal Synostosis: A Comparison of Perioperative Morbidity and Short-Term Outcomes

Tahiri, Youssef ; Swanson, Jordan W ; Taylor, Jesse A

United States

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