Based on the experience at one of the largest centers for craniosynostosis and craniofacial malformations, this book reports on the clinical use of a rare technique known as Frontofacial Monobloc Advancement (FFMBA), one of the most rewarding procedures for upper- and mid-face reconstruction in patients with faciocraniosynostosis, a rare craniofacial anomaly associated with premature fusion of multiple cranial sutures presenting with brachycephaly, orbital proptosis, maxillary hypoplasia and anterior crossbite.
Technical refinements and strategic planning have made it almost a routine procedure at the French Reference Center for Craniosynostosis and Craniofacial Malformations.
This easy-to-consult, well illustrated book includes technical tips and indications for its use in Crouzon, Pfeiffer and Apert syndromes. It also provides a protocol, including a proposed management algorithm for faciocraniosynostosis. As such, it will appeal to craniofacial surgeons, especially those at large craniofacial centers.
Author(s): Eric Arnaud, Giovanna Paternoster, Roman Hossein Khonsari, Samer E. Haber
Publisher: Springer
Year: 2023
Language: English
Pages: 326
City: Cham
Preface
Contents
List of Contributors
Abbreviations
1: Introduction: A Simplified Strategy for Complex Craniosynostotic Conditions
References
2: Intracranial Pressure Management and Posterior Vault Distraction
2.1 Historical Evolution of the Strategy of Care
2.2 Technical Tips for PVE with Distraction
2.3 Spring-Assisted Expansion (Figs. 2.5, 2.8, 2.9, 2.10, 2.11, and 2.12)
2.4 Posterior Vault Expansion with Distractors (Figs. 2.13 and 2.14)
2.5 PVE without Springs or Distractors (Figs. 2.15, 2.16, and 2.17)
2.6 PVE and Tonsillar Herniation
2.7 Biparietal Decompression
2.8 Posterior Expansion as an Essential Tool to Correct Turricephalic Head (Fig. 2.22)
References
3: Standardization of the Fronto-facial Monobloc Advancement Technique Developed at Necker-Enfants Malades Hospital
4: Postoperative Analysis after Fronto-facial Monobloc Advancement
4.1 Anterior Skull Analysis After FFMBA
4.1.1 Frontal and Zygomatic Arch Re-ossification after FFMBA
4.1.2 Anterior Skull Base Re-ossification after FFMBA
4.1.3 Supraorbital Ridge Bone Thickness
4.2 Orbital Shape and Optic Nerve Modifications after FFMBA in Crouzon Syndrome
4.2.1 Eyelids and FFMBA
4.2.2 FFMBA Is a Powerful Tool to Enlarge the Orbit and Reduce Exorbitism
4.3 FFMBA Improves OSAS in Faciocraniosynostosis
References
5: Secondary Le Fort III Facial Advancement after Primary Fronto-facial Monobloc Advancement: Effects on Sleep Apnea Syndrome
5.1 Operative Technique: Secondary Le Fort III Facial Advancement with External and Internal Distraction (Fig. 5.2)
5.2 Technical Adaptations
5.3 Amount of Advancement
5.4 Durability of the Advancement
References
6: Very Early Monobloc: A Procedure for Extreme Conditions with Transfacial External Traction and Internal Distraction
6.1 Alternative to External Traction with the Insertion of the Transfacial Pin Alone with 4 Internal Distractors
References
7: Tracheostomy Management: How FFMBA Contributes to the Removal?
References
8: Dental Consequences of FFMBA
References
9: Complications After Fronto-facial Monobloc Advancement
10: Treatment Strategies in Faciocraniosynostosis
10.1 Treatment Strategies in Crouzon Syndrome
10.1.1 Example №1 of Management Strategy in Crouzon Syndrome
10.1.2 Example №2 of Management Strategy in Crouzon Syndrome
10.1.3 Example №3 of Management Strategy in Crouzon Syndrome
10.1.4 Example №4 of Management Strategy in Crouzon Syndrome
10.1.5 Example № 5 of Management Strategy in Crouzon Syndrome
10.1.6 Example №6 of Management Strategy in Crouzon Syndrome
10.1.7 Example №7 of Management Strategy in Crouzon Syndrome
10.1.8 Example №8 of Management Strategy in Crouzon Syndrome
10.2 Treatment Strategies in Pfeiffer Syndrome
10.2.1 Example №1 of Management Strategy in Pfeiffer Syndrome
10.2.2 Example №2 of Management Strategy in Pfeiffer Syndrome
10.2.3 Example №3 of Management Strategy in Pfeiffer Syndrome
10.2.4 Example №4 of Management Strategy in Pfeiffer Syndrome
10.3 Treatment Strategies in Apert Syndrome
10.3.1 Example №1 of Management Strategy in Apert Syndrome
10.3.2 Example №2 of Management Strategy in Apert Syndrome
10.3.3 Example №3 of Management Strategy in Apert Syndrome
References
11: Aesthetic Refinements in Faciocraniosynostosis Surgery
11.1 Bicoronal Scar Revision
11.2 Burring of Frontal/Calvarial Irregularities
11.3 Frontal Sinus Reduction (Particularly in Apert Syndrome)
11.4 Lateral Canthopexy
11.5 Medial Canthopexy
11.6 Fat Grafting in the Temporal and Zygomatic Regions
11.7 Genioplasty (Advancement Type)
11.8 Rhinoseptoplasty (Especially after LF3)
11.9 Specific Aesthetic Refinements in Crouzon Syndrome
11.10 Specific Aesthetic Refinements in Apert Syndrome
References
12: Conclusions
