Craniosynostosis: Monobloc Distraction with Internal Device and Its Variant for Infants with Severe Syndromic Craniosynostosis

Giovanna Paternoster; Samer Elie Haber; Roman Hossein Khonsari; Syril James; Eric Arnaud

doi:10.1016/j.cps.2021.02.008

Craniosynostosis: Monobloc Distraction with Internal Device and Its Variant for Infants with Severe Syndromic Craniosynostosis

Clin Plast Surg. 2021 Jul;48(3):497-506. doi: 10.1016/j.cps.2021.02.008. Epub 2021 May 8.

Authors

Giovanna Paternoster¹, Samer Elie Haber¹, Roman Hossein Khonsari², Syril James³, Eric Arnaud⁴

Affiliations

¹ Unité fonctionnelle de chirurgie craniofaciale, Service de Neurochirurgie Pédiatrique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares CRANIOST, Filière Maladies Rares TeteCou, Université Paris Descartes, ERN Cranio, 149 rue de Sèvres, 75015, Paris, France.
² Unité fonctionnelle de chirurgie craniofaciale, Service de Neurochirurgie Pédiatrique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares CRANIOST, Filière Maladies Rares TeteCou, Université Paris Descartes, ERN Cranio, 149 rue de Sèvres, 75015, Paris, France; Service de chirurgie maxillofaciale et chirurgie plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares CRANIOST, Filière Maladies Rares TeteCou, Université de Paris, Université Paris Descartes, 149 rue de Sèvres, 75015, Paris, France.
³ Unité fonctionnelle de chirurgie craniofaciale, Service de Neurochirurgie Pédiatrique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares CRANIOST, Filière Maladies Rares TeteCou, Université Paris Descartes, ERN Cranio, 149 rue de Sèvres, 75015, Paris, France; Clinique Marcel Sembat, Ramsay Générale de Santé, 105 boulevard Victor Hugo, 92100 Boulogne, France.
⁴ Unité fonctionnelle de chirurgie craniofaciale, Service de Neurochirurgie Pédiatrique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares CRANIOST, Filière Maladies Rares TeteCou, Université Paris Descartes, ERN Cranio, 149 rue de Sèvres, 75015, Paris, France; Clinique Marcel Sembat, Ramsay Générale de Santé, 105 boulevard Victor Hugo, 92100 Boulogne, France. Electronic address: drericarnaud@hotmail.com.

PMID: 34051901
DOI: 10.1016/j.cps.2021.02.008

Abstract

The introduction of distraction osteogenesis to frontofacial monobloc advancement has increased the safety of the procedure. One hundred forty-seven patients with syndromic craniosynostosis underwent frontofacial monobloc advancement using 4 internal distractors. Twenty-five were aged 18 months or less. Ten patients presented with a tracheostomy, 5 (50%) were decannulated after surgery, and 3 others (30%) required an additional intervention before decannulation. Six patients required the addition of a transfacial pin and external traction. Very early frontofacial monobloc with 4 internal distractors is a safe and effective treatment to protect the ophthalmic, neurologic, and respiratory functions in infants with severe syndromic craniosynostosis.

Keywords: Craniofacial dysostosis; Distraction osteogenesis; Exorbitism; Faciocraniosynostosis; Frontofacial monobloc advancement; Sleep apnea; Syndromic craniosynostosis; Tracheostomy.

Publication types

Review

MeSH terms

Craniofacial Dysostosis / complications
Craniofacial Dysostosis / surgery*
Craniosynostoses / complications
Craniosynostoses / surgery
Facial Bones / abnormalities
Facial Bones / surgery
Female
Humans
Infant
Male
Occlusal Splints
Osteogenesis, Distraction / instrumentation
Osteogenesis, Distraction / methods*
Sleep Apnea Syndromes / etiology
Sleep Apnea Syndromes / surgery
Tracheostomy