The Role of Bipartition Distraction in the Treatment of Apert Syndrome

Plastic and Reconstructive Surgery
Graeme E GlassD J Dunaway

Abstract

Apert syndrome is characterized by hypertelorism, a negative canthal axis, and central midfacial hypoplasia, resulting in a biconcave face. Bipartition distraction partially corrects these facial anomalies. This study investigates limitations of bipartition distraction using linear, angular, and geometric morphometric analysis. Preoperative and postoperative three-dimensional computed tomographic craniofacial constructs of 10 patients with Apert syndrome (aged 12 to 21 years) were annotated with 98 landmarks. Twelve age-, sex, and ethnicity-matched normal skulls provided control data. Principal component analysis was used to analyze shape characteristics within and between the groups and describe the changes occurring with surgery. Results were displayed graphically using difference color maps. Conventional point-based measurements documented midfacial width, height, and asymmetry. Apert three-dimensional constructs exhibited reduced upper midfacial height and greater extrinsic symmetric variation relative to controls. Facial bipartition partially corrected excessive midfacial width and interorbital distance but did not adequately correct deficient upper midfacial height. Excessive orbital diameter was unaltered by surgery. The...Continue Reading

References

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Citations

Jan 20, 2021·Scientific Reports·Petros RoussosIosif Sifakakis
May 10, 2021·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Chad A PurnellRichard A Hopper
May 31, 2021·Clinics in Plastic Surgery·David J DunawayNoor Ul Owase Jeelani
May 31, 2021·Clinics in Plastic Surgery·Cassio Eduardo Raposo-AmaralCesar Augusto Raposo-Amaral
Jun 30, 2021·Current Opinion in Otolaryngology & Head and Neck Surgery·Henya Sandhaus, Matthew D Johnson
Jul 16, 2021·The Journal of Craniofacial Surgery·Cassio Eduardo Raposo-AmaralEnrico Ghizoni

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