Counterclockwise Craniofacial Distraction Osteogenesis - 26/05/21

Doi : 10.1016/j.cps.2021.02.006

Richard A. Hopper, MD, MS ^a,^b,^⁎ , Howard D. Wang, MD ^a,^b, Ezgi Mercan, PhD ^a, Hitesh Kapadia, PhD ^a,^b,^c
^a The Craniofacial Center, Seattle Children’s Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA
^b Division of Plastic Surgery, Department of Surgery, University of Washington
^c Department of Orthodontics, School of Dentistry, University of Washington

^∗Corresponding author. Division of Craniofacial and Plastic Surgery, Seattle Children’s Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105.Division of Craniofacial and Plastic SurgerySeattle Children’s Hospital4800 Sand Point Way NortheastSeattleWA98105

Résumé

Anatomic studies have identified that patients with Treacher Collins syndrome and some cases of bilateral craniofacial microsomia are characterized by multilevel airway obstruction as a result of hypoplasia and clockwise rotation of the maxillomandibular complex. Patients often remain tracheostomy-dependent despite multiple airway surgeries. Counterclockwise craniofacial distraction osteogenesis aims to correct the facial skeletal deformity and expand the upper airway volume by rotating the subcranial complex en bloc around the nasofrontal junction. Early results have demonstrated significant increases in the nasopharyngeal and oropharyngeal airway volumes with successful decannulation in a majority of patients who have undergone this operation.

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Keywords : Treacher Collins syndrome, Craniofacial microsomia, Hemifacial microsomia, Midface hypoplasia, Distraction osteogenesis, Midface distraction, Mandibular distraction, Upper airway obstruction