Skip to main content

Facial Bipartition Distraction

  • Chapter
  • First Online:
  • 795 Accesses

Abstract

Bipartition distraction is a novel procedure combining frontofacial bipartition and monobloc distraction. Apert syndrome and other syndromic craniofacial dysostoses are often characterised by hypertelorism, with a negative canthal axis and counter-rotated orbits. Central midface hypoplasia can result in a biconcave face in both midsagittal and axial planes. Bipartition distraction is an effective procedure to differentially advance the central face in Apert syndrome and improves both function and aesthetics.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Greig AV, Britto JA, Abela C, et al. Correcting the typical Apert face: combining bipartition with monobloc distraction. Plast Reconstr Surg. 2013;131(2):219e–30e.

    Article  CAS  PubMed  Google Scholar 

  2. Forte AJ, Alonso N, Persing JA, Pfaff MJ, Brooks ED, Steinbacher DM. Analysis of midface retrusion in Crouzon and Apert syndromes. Plast Reconstr Surg. 2014;134(2):285–93.

    Article  CAS  PubMed  Google Scholar 

  3. Ponniah AJ, Witherow H, Richards R, Evans R, Hayward R, Dunaway D. Three-dimensional image analysis of facial skeletal changes after monobloc and bipartition distraction. Plast Reconstr Surg. 2008;122(1):225–31.

    Article  CAS  PubMed  Google Scholar 

  4. Kreiborg S, Cohen Jr MM. Ocular manifestations of Apert and Crouzon syndromes: qualitative and quantitative findings. J Craniofac Surg. 2010;21(5):1354–7.

    Article  PubMed  Google Scholar 

  5. Ortiz-Monasterio F, del Campo AF, Carrillo A. Advancement of the orbits and the midface in one piece, combined with frontal repositioning, for the correction of Crouzon’s deformities. Plast Reconstr Surg. 1978;61(4):507–16.

    Article  CAS  PubMed  Google Scholar 

  6. van der Meulen JC. Medial faciotomy. Br J Plast Surg. 1979;32(4):339–42.

    Article  PubMed  Google Scholar 

  7. Tessier P. Apert syndrome: acrocephalosyndactyly type 1. In: Caronni EP, editor. Craniofacial surgery. Boston: Little Brown; 1985. p. 280–303.

    Google Scholar 

  8. Flores RL, Shetye PR, Zeitler D, et al. Airway changes following Le Fort III distraction osteogenesis for syndromic craniosynostosis: a clinical and cephalometric study. Plast Reconstr Surg. 2009;124(2):590–601.

    Article  CAS  PubMed  Google Scholar 

  9. Gosain AK, Santoro TD, Havlik RJ, Cohen SR, Holmes RE. Midface distraction following Le Fort III and monobloc osteotomies: problems and solutions. Plast Reconstr Surg. 2002;109(6):1797–808.

    Article  PubMed  Google Scholar 

  10. Denny AD, Kalantarian B, Hanson PR. Rotation advancement of the midface by distraction osteogenesis. Plast Reconstr Surg. 2003;111(6):1789–99; discussion 1800–1783.

    Article  PubMed  Google Scholar 

  11. Bradley JP, Gabbay JS, Taub PJ, et al. Monobloc advancement by distraction osteogenesis decreases morbidity and relapse. Plast Reconstr Surg. 2006;118(7):1585–97.

    Article  CAS  PubMed  Google Scholar 

  12. Hayward RJB, Dunaway D. The clinical management of craniosynostosis. Cambridge: Cambridge University Press; 2004.

    Google Scholar 

  13. Fearon JA. Halo distraction of the Le Fort III in syndromic craniosynostosis: a long-term assessment. Plast Reconstr Surg. 2005;115(6):1524–36.

    Article  CAS  PubMed  Google Scholar 

  14. Shetye PR, Kapadia H, Grayson BH, McCarthy JG. A 10-year study of skeletal stability and growth of the midface following Le Fort III advancement in syndromic craniosynostosis. Plast Reconstr Surg. 2010;126(3):973–81.

    Article  CAS  PubMed  Google Scholar 

  15. Polley JW, Figueroa AA, Charbel FT, Berkowitz R, Reisberg D, Cohen M. Monobloc craniomaxillofacial distraction osteogenesis in a newborn with severe craniofacial synostosis: a preliminary report. J Craniofac Surg. 1995;6(5):421–3.

    Article  CAS  PubMed  Google Scholar 

  16. Witherow H, Thiessen F, Evans R, Jones BM, Hayward R, Dunaway D. Relapse following frontofacial advancement using the rigid external distractor. J Craniofac Surg. 2008;19(1):113–20.

    Article  PubMed  Google Scholar 

  17. Arnaud E, Marchac D, Renier D. Quadruple internal distraction with early frontal-facial avancement for faciocraniodysostosis. Rev Stomatol Chir Maxillofac. 2004;105(1):13–8.

    Article  CAS  PubMed  Google Scholar 

  18. Polley JW, Figueroa AA. Management of severe maxillary deficiency in childhood and adolescence through distraction osteogenesis with an external, adjustable, rigid distraction device. J Craniofac Surg. 1997;8(3):181–5; discussion 186.

    Article  CAS  PubMed  Google Scholar 

  19. Hansman CF. Growth of interorbital distance and skull thickness as observed in roentgenographic measurements. Radiology. 1966;86(1):87–96.

    Article  CAS  PubMed  Google Scholar 

  20. Tessier P, Guiot G, Derome P. Orbital hypertelorism. II. Definite treatment of orbital hypertelorism (OR.H.) by craniofacial or by extracranial osteotomies. Scand J Plast Reconstr Surg. 1973;7(1):39–58.

    Google Scholar 

  21. Dunaway DJ, Britto JA, Abela C, Evans RD, Jeelani NU. Complications of frontofacial advancement. Childs Nerv Syst. 2012;28(9):1571–6.

    Article  PubMed  Google Scholar 

  22. Crombag GA, Verdoorn MH, Nikkhah D, Ponniah AJ, Ruff C, Dunaway D. Assessing the corrective effects of facial bipartition distraction in Apert syndrome using geometric morphometrics. J Plast Reconstr Aesthet Surg. 2014;67(6):e151–61.

    Article  PubMed  Google Scholar 

  23. McCarthy JG, Glasberg SB, Cutting CB, et al. Twenty-year experience with early surgery for craniosynostosis: II. The craniofacial synostosis syndromes and pansynostosis—results and unsolved problems. Plast Reconstr Surg. 1995;96(2):284–95; discussion 296–288.

    Google Scholar 

  24. Allam KA, Wan DC, Khwanngern K, et al. Treatment of apert syndrome: a long-term follow-up study. Plast Reconstr Surg. 2011;127(4):1601–11.

    Article  CAS  PubMed  Google Scholar 

  25. Posnick JC, Ruiz RL, Tiwana PS. Craniofacial dysostosis syndromes: stages of reconstruction. Oral Maxillofac Surg Clin North Am. 2004;16(4):475–91.

    Article  PubMed  Google Scholar 

  26. Meazzini MC, Allevia F, Mazzoleni F, et al. Long-term follow-up of syndromic craniosynostosis after Le Fort III halo distraction: a cephalometric and CT evaluation. J Plast Reconstr Aesthet Surg. 2012;65(4):464–72.

    Article  PubMed  Google Scholar 

  27. Marchac D, Renier D, Broumand S. Timing of treatment for craniosynostosis and facio-craniosynostosis: a 20-year experience. Br J Plast Surg. 1994;47(4):211–22.

    Article  CAS  PubMed  Google Scholar 

  28. Shetye PR, Davidson EH, Sorkin M, Grayson BH, McCarthy JG. Evaluation of three surgical techniques for advancement of the midface in growing children with syndromic craniosynostosis. Plast Reconstr Surg. 2010;126(3):982–94.

    Article  CAS  PubMed  Google Scholar 

  29. Oberoi S, Hoffman WY, Vargervik K. Craniofacial team management in Apert syndrome. Am J Orthod Dentofac Orthop. 2012;141(4 Suppl):S82–7.

    Article  Google Scholar 

  30. Satoh K, Mitsukawa N, Hosaka Y. Dual midfacial distraction osteogenesis: Le Fort III minus I and Le Fort I for syndromic craniosynostosis. Plast Reconstr Surg. 2003;111(3):1019–28.

    Article  PubMed  Google Scholar 

  31. Witherow H, Dunaway D, Evans R, et al. Functional outcomes in monobloc advancement by distraction using the rigid external distractor device. Plast Reconstr Surg. 2008;121(4):1311–22.

    Article  CAS  PubMed  Google Scholar 

  32. Ko EW, Chen PK, Tai IC, Huang CS. Fronto-facial monobloc distraction in syndromic craniosynostosis. Three-dimensional evaluation of treatment outcome and facial growth. Int J Oral Maxillofac Surg. 2012;41(1):20–7.

    Article  PubMed  Google Scholar 

  33. Moreira Gonzalez A, Elahi M, Barakat K, Yavuzer R, Brinkmann B, Jackson IT. Hypertelorism: the importance of three-dimensional imaging and trends in the surgical correction by facial bipartition. Plast Reconstr Surg. 2005;115(6):1537–46.

    Article  PubMed  Google Scholar 

  34. Hopper RA, Kapadia H, Morton T. Normalizing facial ratios in apert syndrome patients with Le Fort II midface distraction and simultaneous zygomatic repositioning. Plast Reconstr Surg. 2013;132(1):129–40.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David J. Dunaway F.D.S.R.C.S., F.R.C.S. (Plast.) .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Greig, A.V.H., Dunaway, D.J. (2017). Facial Bipartition Distraction. In: McCarthy, J. (eds) Craniofacial Distraction. Springer, Cham. https://doi.org/10.1007/978-3-319-52564-8_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-52564-8_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52562-4

  • Online ISBN: 978-3-319-52564-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics