Abstract
Introduction: Anterior cranial distraction osteogenesis has been proposed as an effective technique for expending the anterior cranial volume to avoid intracranial hypertension. Mostly studies have focused on volumetric changes in different surgical approaches such as fronto-orbital advancement and posterior cranial vault distraction osteogenes. However the direction of distraction can also affect the outcome. So the aim of this study was to analyze the effects of three different directions of anterior cranial distraction osteogenesis, these are 15 degrees forward and downward, horizontal distraction, 15 degrees forward and upward. Methods: This was a retrospective chart review performed between 2015 to 2018 at a the department of plastic surgery in the children`s hospital of Nanjing medical university. 24 patients were included in this study. We divided the patients into three groups according to the three directions of anterior cranial distraction osteogenesis. Each group has ten (10) patients. All the patients were performed the CT scan preoperatively and postoperatively. The CT databases were processed by DICOM files into MIMICS software, which were automatically calculated into anterior cranial volume. Then we calculated the percentage increase in anterior cranial volume of each group. Results: The mean increase volume was 64±17ml for 15 degrees forward and downward group 44±15 mlfor horizontal distraction group and 38±12ml for 15 degrees forward and upward group. The mean difference in anterior cranial volume between the 15 degrees forward and downward group and horizontal distraction group and 15 degrees forward and upward group was significantly increased (P <0.05) Conclusion: In this retrospective study, 15 degrees forward and downward group in anterior cranial vault distraction osteogenesis provided statistically greater anterior cranial volume expansion than the other two angles.
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