Hemi one-piece distraction osteogenesis for unilateral coronal craniosynostosis

J Craniomaxillofac Surg. 2024 Feb;52(2):252-259. doi: 10.1016/j.jcms.2023.12.010. Epub 2023 Dec 28.

Abstract

Introduction: It was the aim of the study to assess the efficacy of the hemi one-piece distraction osteogenesis and to compare it to the traditional one-piece distraction osteogenesis technique.

Methods: Two different surgical techniques were used; the one-piece distraction and the hemi one-piece distraction. The principal distinction between the two techniques is that in the hemi style approach, the intact sutures on the contralateral side were left undisturbed, with no osteotomy performed.

Results: The hemi one-piece group had a significantly lower median value of plastic surgery time, total operation time, and transfusion rate (plastic surgery time 69 min (range 65-120) vs. 20 min (range 17-32.5), p < 0.001; transfusion 80 mL (range 0-150) vs. 0 mL (0-60), p = 0.1. Nasofrontal advancement was successful with no major complications. Median endocranial angulation improved (one-piece: 166.1°-176.0°, hemi: 162.9°-173.0°, p = 0.023 & p = 0.012 respectively).

Conclusion: This study reveals less invasive, highly effective techniques for craniosynostosis treatment, notably a unilateral osteotomy with distraction method. Nevertheless, to confirm their long-term efficacy and durability, more studies with longer follow-ups are essential.

MeSH terms

  • Craniosynostoses* / surgery
  • Craniotomy / methods
  • Humans
  • Osteogenesis, Distraction* / methods
  • Osteotomy
  • Plastic Surgery Procedures*