Hirokatsu Osawa1, Mihoko Kato2, Masamune Nagakura2, Tsuyoshi Morishita3, Goro Kondo4, Michihiro Kurimoto4. 1. Department of Neurosurgery, Aichi Children's Health and Medical Center, 7-426 Morioka-cho, Obu city, Aichi, 474-8710, Japan. hi-osawa@mub.biglobe.ne.jp. 2. Department of Neurosurgery, Aichi Children's Health and Medical Center, 7-426 Morioka-cho, Obu city, Aichi, 474-8710, Japan. 3. Department of Plastic & Reconstructive Surgery, Aichi Children's Health and Medical Center, Obu city, Aichi, Japan. 4. Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Abstract
BACKGROUND: Distraction osteogenesis is a standard method for craniosynostosis. However, the technique using conventional devices still has some disadvantages, especially for anterior or posterior plagiocephaly with complex deformities. In the Nakajima's angle-variable internal distraction (NAVID) system originally for maxillary surgeries, the cranial three-dimension (D) distractor with three dimensionally movable joint at the anterior arm has been developed recently in order to prevent the interference in the distraction process and excessive force. CASE REPORTS: In this paper, we first reported two cases of anterior plagiocephaly, and one case of posterior plagiocephaly received distraction osteogenesis using new 3-D distractor in the NAVID system. In two cases of anterior plagiocephaly, the reshaping of supra-orbital bar in reference of simulating by the 3-D skull model was performed. In all cases, we fixed two paralleled 2-D distractors and a 3-D distractor in the upper frontal or parietal region. CONCLUSION: Within the limitations of this study, we believe that the NAVID system is suitable for infant plagiocephaly due to the simple and small joint arm. Furthermore, the usage of the 3-D distractor would reduce the interference with 2-D distractors and easily lead to attainment of targeted distracting distance.
BACKGROUND: Distraction osteogenesis is a standard method for craniosynostosis. However, the technique using conventional devices still has some disadvantages, especially for anterior or posterior plagiocephaly with complex deformities. In the Nakajima's angle-variable internal distraction (NAVID) system originally for maxillary surgeries, the cranial three-dimension (D) distractor with three dimensionally movable joint at the anterior arm has been developed recently in order to prevent the interference in the distraction process and excessive force. CASE REPORTS: In this paper, we first reported two cases of anterior plagiocephaly, and one case of posterior plagiocephaly received distraction osteogenesis using new 3-D distractor in the NAVID system. In two cases of anterior plagiocephaly, the reshaping of supra-orbital bar in reference of simulating by the 3-D skull model was performed. In all cases, we fixed two paralleled 2-D distractors and a 3-D distractor in the upper frontal or parietal region. CONCLUSION: Within the limitations of this study, we believe that the NAVID system is suitable for infantplagiocephaly due to the simple and small joint arm. Furthermore, the usage of the 3-D distractor would reduce the interference with 2-D distractors and easily lead to attainment of targeted distracting distance.
Entities:
Keywords:
3D distractor; Craniosynostosis; Distraction osteogenesis; Plagiocephaly
Authors: Daniel Nowinski; Federico Di Rocco; Dominique Renier; Christian SainteRose; Junnu Leikola; Eric Arnaud Journal: Childs Nerv Syst Date: 2012-08-08 Impact factor: 1.475