Distraction Osteogenesis of One-piece Fronto-orbital Bone Flap in the Treatment of Frontal Plagiocephaly.

Hong, Jong Won; Kim, Youg Oock; Park, Beyoung Yun

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Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2003;30(3):326-330.
Published online May 1, 2003.

Distraction Osteogenesis of One-piece Fronto-orbital Bone Flap in the Treatment of Frontal Plagiocephaly.

Jong Won Hong, Youg Oock Kim, Beyoung Yun Park

¹Institute of Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea.
²Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea. sgm625@yumc.yonsei.ac.kr

Abstract

Plagiocephaly is a premature synostosis of the coronal suture in infants and results in deformities of the cranial bone and facial contour. The ipsilateral forehead is underdeveloped with a short width and due to compensatory brain growth, the greater and lesser wings of the ipsilateral sphenoid bones are displaced supero- anteriorly with the greater wing expanded laterally. The coronal suture is located anterior to the presumed line and the sagittal line is curved towards the lesion. The generally, treatment is skull reshaping by frontal or fronto-orbital advancement. Many complications have decreased due to advances in surgical technology and experienced team approach, however complications such as long operation time, excessive bleeding, recurrence, bone absorption and infection are still reported. The authors include the anterior process of the zygoma and the superior orbital wall with the lesion in one piece of the osteocutaneous flap while the other flap do not include them. An absorbable plate is used so that the normal side may have rotation movement while an external distractor is applied to the lesion side for the superior orbital wall to move in an anterior and superior vector. 25 mm were advanced during the 4th to 19th postoperative day and achieved satisfactory results. Almost complete bone formation was confirmed with a computed-tomography exam 6 months postoperatively.

Keywords: Unilateral frontal plagiocephaly; Distraction osteogenesis

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