OBJECTIVETo probe the possibility of trans-sutural distraction osteogenesis for correction of children midfacial hypoplasia.

METHODSThe trans-sutural distraction system of mid-facial skeleton consisted of the bone-borne traction hooks of titanium, the face-bow, and the elastic loops. Nine children with midfacial hypoplasia were treated at their 6 - 12 years of age. No osteotomy was made in them. Bone holes were drilled with a dental bur at each side of the lateral-inferior rim of the aperture, or at the anterior part of the hard palate. The traction device was hatched to the holes through the nostrils. Protraction began 3 days postoperatively, with the forces adjusted dependently upon the rate of progress. When the skeleton reached to the planed position, it was retained with a minor force for 8 weeks.

RESULTSThe mid-facial skeleton of the nine children showed a balanced advancement. Their facial profile and cross-bite were corrected satisfactory.

CONCLUSIONSPatients with severe mid-facial hypoplasia could be corrected ideally by the new technique, with minor trauma, easy manipulation. The design of protraction system was reasonable.

Child ; Humans ; Maxillofacial Abnormalities ; surgery ; Oral Surgical Procedures ; methods ; Orbit ; abnormalities ; surgery ; Osteogenesis, Distraction ; methods ; Skull ; abnormalities ; surgery ; Treatment Outcome

Adult ; Dandy-Walker Syndrome ; diagnosis ; surgery ; Female ; Humans ; Neurofibromatosis 1 ; diagnosis ; surgery ; Skull ; abnormalities

In orthodontics and orthognathic surgery, cephalogram has been routine practice in diagnosis and treatment evaluation of craniofacial deformity. But its inherent distortion of actual length and angles during projecting three dimensional object to two dimensional plane might cause errors in quantitative analysis of shape and size. Therefore, it is desirable that three dimensional object is diagnosed and evaluated three dimensionally and three dimensional CT image is best for three dimensional analysis. Development of clinic necessitates evaluation of result of treatment and comparison before and after surgery. It is desirable that patient that was diagnosed and planned by three dimensional computed tomography before surgery is evaluated by three dimensional computed tomography after surgery, too. But Because there is no standardized normal values in three dimension now and three dimensional Computed Tomography needs expensive equipments and because of its expenses and amount of exposure to radiation, limitations still remain to be solved in its application to routine practice. If postoperative three dimensional image is constructed by pre and postoperative lateral and postero-anterior cephalograms and preoperative three dimensional computed tomogram, pre and postoperative image will be compared and evaluated three dimensionally without three dimensional computed tomography after surgery and that will contribute to standardize normal values in three dimension. This study introduced new method that computer-simulated three dimensional image was constructed by preoperative three dimensional computed tomogram and pre and postoperative lateral and postero-anterior cephalograms, and for validation of new method, in four cases of dry skull that position of mandible was displaced and four patients of orthognathic surgery, computer-simulated three dimensional image and actual postoperative three dimensional image were compared. The results were as follows. 1. In four cases of dry skull that position of mandible was displaced, range of displacement between computer-simulated three dimensional images and actual postoperative three dimensional images in co-ordinates values was from -1.8 mm to 1.8 mm and 94% in displacement of all co-ordinates values was from -1.0 mm to 1.0 mm and no significant difference between computer-simulated three dimensional images and actual postoperative three dimensional images was noticed(p>0.05). 2. In four cases of orthognathic surgery patients, range of displacement between computer-simulated three dimensional images and actual postoperative three dimensional images in co-ordinates values was from -6.7 mm to 7.7 mm and 90% in displacement of all co-ordinates values was from -4.0 to 4.0 mm and no significant difference between computer-simulated three dimensional images and actual postoperative three dimensional images was noticed(p>0.05). Conclusively, computer-simulated three dimensional image was constructed by preoperative three dimensional computed tomogram and pre and postoperative lateral and postero-anterior cephalograms. Therefore, potentiality that can construct postoperative three dimensional image without three dimensional computed tomography after surgery was presented.
Congenital Abnormalities ; Diagnosis ; Humans ; Imaging, Three-Dimensional ; Mandible ; Orthodontics ; Orthognathic Surgery* ; Reference Values ; Skull

Fibrous dysplasia is a bone disease of unknown etiology in which cellular fibrous tissue gradually replaces normal bone and involves the cranium infrequently. Recently, we have experienced 3 cases of fibrous dysplasia which involved the frontal, sphenoid and parietal bones with vault deformity. The 2 cases, in which the frontal and sphenoid bones were involved, presented with proptosis and exophthalmos. All of the cases manifested vault deformity which caused cosmetic problems. We performed decompressive and plastic surgery for the purpose of relieving the compression of cranial nerves and for the sake of the cosmetic effect. The clinical courses were uneventful.
Bone Diseases ; Congenital Abnormalities ; Cranial Nerves ; Exophthalmos ; Parietal Bone ; Skull ; Sphenoid Bone ; Surgery, Plastic

OBJECTIVETo investigate the technique of skull reconstruction for the congenital craniosynostosis.

METHODSMany technique of skull plasty were adopted to correct the congenital craniosynostosis. We advanced fronto-orbital, reversal change of the frontal bone to correct the brachycephalic, hydrocephaly acrocephaly, which were supported by parietal bone. Plum-plasty of the calvaria was performed for sagittal synostosis; Fronto-orbital plasty correct the trigonocephaly; for single coronal synostosis, which result to frontal plagiocephaly,we reversed both frontal sides, advanced orbital strip and tilted the invalid side . The post plagiocephaly because of single Lambdoid synostosis, we performed of plum-plasty, reversal change of total occipital. Fronota-facial advancement cured the brachycephalic complicating with Apert or Crouzon which caused by coronal synostosis and cranial basal suture synostosis.

RESULTS37 cases were recovery without complication. The figures were improved.

CONCLUSIONSBig calvarial flap plasty is an optimal technique to correct the congenital craniosynostosis. But it is not substituted by bone lengthening and minimally invasive technique.

Child, Preschool ; Cranial Sutures ; abnormalities ; Craniosynostoses ; surgery ; Female ; Humans ; Infant ; Male ; Reconstructive Surgical Procedures ; methods ; Skull ; surgery

Oxycephaly, which is a frontal deformity in which the forehead is recessed and tilted backwards, is usually caused by the premature fusion of mainly the coronal and sagittal suture. In 1926, David M. Greig proposed to classify oxycephaly into three different forms; true oxycephaly, delayed oxycephaly and false oxycephaly. False oxycephaly is a simple morphotype of the skull without any clinical symptoms which does not affect the brain in any way. Surgical repair of oxycephaly for adults can include cosmetic considerations and the prevention or possible improvement of functional symptoms such as headaches, vomiting and visual disturbance. Furthermore, in adults who does not have any functional problems, cosmetic surgery can be done. But oxycephaly of adult patients need more complex and extensive surgical interventions than that of infant patients. A-21-year-old male who had a retroverted forehead, pointed head and a flat fronto-nasal angle, without any functional problems, was treated by a fronto- orbital advancement and a transposition between the frontal and fronto-parietal bone. This method provided us with a good frontonasal angle and a gently backward sloping forehead above the supraorbital bar. An acceptable aesthetic appearance was achieved 6 months after the operation. This remodeling technique is adequate for resolving the aesthetic problems of adult false oxycephalic patients who does not have any functional problems.
Adult* ; Brain ; Congenital Abnormalities ; Craniosynostoses* ; Forehead ; Head ; Headache ; Humans ; Infant ; Male ; Orbit ; Skull ; Surgery, Plastic ; Sutures ; Vomiting

surgery and reconstruction, and esthetic surgery. Complications were such as injury to frontal branch of the facial nerve, motor nerve paralysis, hematoma under flap, trismus, ptosis, epiphora, infection and anterior temporal depression. Medpor(R) is made up of dense polyethylene connected in porous structures. It is easily shapable without collapsing the pores due to it's hardness and tissue growth takes place at the porosities. Based on these advantages, Medpor(R) has been used in augmentation and restoration in craniofacial defect. A temporal depression after the coronal approach for treatment of Le Fort III fracture was successfully reconstruction with Medpor(R) and we report this case with review of literature.]]>
Congenital Abnormalities ; Depression ; Facial Nerve ; Hardness ; Hematoma ; Lacrimal Apparatus Diseases ; Paralysis ; Polyethylene ; Porosity ; Skull ; Surgery, Plastic ; Trismus

Intraosseous haemangiomas (IOHs) are benign vascular bone tumours that account for 1% of all primary bone tumours. They are most frequently seen in the vertebrae and skull, and are rarely found in long bones. Herein, we present an uncommon case of a 25-year-old woman with a solitary IOH that occupied the left femoral neck. We describe the clinical, radiological and histological details of the case, as well as the three-year outcome of the surgical treatment, which successfully preserved the femoral head. We also conducted a review of the literature on this uncommon entity.
Adult ; Angiography ; Diagnosis, Differential ; Female ; Femur Neck ; blood supply ; Humans ; Magnetic Resonance Imaging ; Skull ; abnormalities ; surgery ; Spine ; abnormalities ; surgery ; Tomography, X-Ray Computed ; Vascular Malformations ; diagnosis ; surgery ; Vascular Surgical Procedures ; methods

PURPOSE: The Dyke-Davidoff-Masson syndrome is a rare disease entity that was first reported in 1993, and it is characterized by not only the cerebral hemiatrophy that is accompanied by the ipsilateral ventriculomegaly and ipsilateral compensatory osseous hypertrophy, but also the overgrowth of the paranasal sinuses. No studies have attempted to examine it from perspectives of the skull deformity and plastic surgery. Here, we report our case with a review of the literatures. METHODS: A 45-year-old man with Dyke-Davidoff-Masson visited our medical institution with nasal bone fracture. Based on the previously taken brain MRI scans, we measured the degree of craniofacial deformity, and the horizontal distance, which is based on the margin of the skull, as well as the falx cerebri. RESULTS: We made a comparison of the degree of craniofacial deformity. This showed that the mean horizontal distance on the axial view was shorter by approximately 28.46%, as compared with that of the left unaffected side. CONCLUSION: The Dyke-Davidoff-Masson is characterized by a concurrent presence of the atrophy of the cerebral hemisphere, with the cranial deformity. For the reconstruction of the bone and soft-tissue deformity with Dyke-Davidoff-Masson syndrome, it is needed to perform objective assessments.
Atrophy ; Brain ; Cerebrum ; Congenital Abnormalities ; Humans ; Hypertrophy ; Magnetic Resonance Imaging ; Middle Aged ; Nasal Bone ; Paranasal Sinuses ; Rare Diseases ; Skull ; Surgery, Plastic

PURPOSE: The Dyke-Davidoff-Masson syndrome is a rare disease entity that was first reported in 1993, and it is characterized by not only the cerebral hemiatrophy that is accompanied by the ipsilateral ventriculomegaly and ipsilateral compensatory osseous hypertrophy, but also the overgrowth of the paranasal sinuses. No studies have attempted to examine it from perspectives of the skull deformity and plastic surgery. Here, we report our case with a review of the literatures. METHODS: A 45-year-old man with Dyke-Davidoff-Masson visited our medical institution with nasal bone fracture. Based on the previously taken brain MRI scans, we measured the degree of craniofacial deformity, and the horizontal distance, which is based on the margin of the skull, as well as the falx cerebri. RESULTS: We made a comparison of the degree of craniofacial deformity. This showed that the mean horizontal distance on the axial view was shorter by approximately 28.46%, as compared with that of the left unaffected side. CONCLUSION: The Dyke-Davidoff-Masson is characterized by a concurrent presence of the atrophy of the cerebral hemisphere, with the cranial deformity. For the reconstruction of the bone and soft-tissue deformity with Dyke-Davidoff-Masson syndrome, it is needed to perform objective assessments.
Atrophy ; Brain ; Cerebrum ; Congenital Abnormalities ; Humans ; Hypertrophy ; Magnetic Resonance Imaging ; Middle Aged ; Nasal Bone ; Paranasal Sinuses ; Rare Diseases ; Skull ; Surgery, Plastic