Application of virtual planning for improvement of four-wall orbitotomy in surgical treatment of craniofacial pathologies

Authors

  • Чингиз Рагим оглы Рагимов
  • Исмаил Махмуд оглы Фарзалиев
  • Гюнель Ильхам кызы Гаджиева

DOI:

https://doi.org/10.33295/1992-576X-2019-5-60

Keywords:

four-wall orbitotomy, craniofacial deformities, virtual planning

Abstract

Purpose. Improvement of efficiency of surgical treatment of patients with craniofacial deformities by application of virtual modelling in preoperative planning of fourwall orbitotomy.
Materials and methods. Current study was done on patients with Cruzon syndrome, and frontonasal dysplasia. Patients passed through accurate clinical investigation done by maxillofacial surgeon, ophthalmologist, neurologist, neurosurgeon, and ENT specialist. Acquired data was documented and augmented by photo and video data received by usage of professional camera Nikon D800 (Minato, Tokyo, Japan). Computer tomography was done on TOSHIBA CT scanner (Aquilion PRIME, Minato,Tokyo, Japan). Acquired data was imported into Materialise Mimic 21 Research virtual planning software package (Leuven, Belgium),
followe d by appropriate virtual measurements, that were used during surgical procedure. Surgery was executed under general anesthesia in collaboration of
maxillofacial surgeon, neurosurgeon and ENT surgeon. Monobloc creation, which part was our-wall orbitotomy was done via coronary approach. In postoperative period careful clinical and radiological comparison was done.
Results. In both clinical cases based no postoperative CT scan data a compliance of real transpositioning of osseous fragments to preplanned was noted. In case of Cruzon syndrome real transpositioning was 11.89 mm; in case of frontonasal dysplasia due to medialization of the orbits intercanthal distance decreased form 34.02 to 24.02 mm, and width of Glabella from 44.09 to 29.84 mm respectively, that was corresponding to preplanned transpositioning. Moreover, because of combination of surgical (osteotomy in creation of monobloc) and orthodontic treatment qualitive changes were noted within occlusion as well. Thus, in first clinical case application of distraction method of traspositioning in combination of orthodontic treatment lead to exchanging of 3rd class occlusion to 2nd; in second case 2nd class and cross-bite occlusion exchanged to 1st class, that finally lead to restoration of upper airways, meal and speech functions.
Conclusions. Application of virtual preoperative planning significantly increasing the outcomes of four-wall orbitotomy in treatment of different craniofacial deformities. Combination of surgical and orthodontic approaches allows to solve issues relate to functional and esthetic parameters of both orbits and occlusion.
Key words: four-wall orbitotomy, craniofacial deformities, virtual planning.

Author Biographies

Чингиз Рагим оглы Рагимов

Рагимов Чингиз Рагим оглы – д-р мед. наук, профессор,
заведующий кафедры хирургии полости рта и челюстно-лицевой области
Азербайджанского медицинского университета, Баку, Азербайджан.

Исмаил Махмуд оглы Фарзалиев

Фарзалиев Исмаил Махмуд оглы – д-р философии по медицине,
ассистент кафедры хирургии полости рта и челюстно-лицевой области
Азербайджанского медицинского университета, Баку, Азербайджан.

Гюнель Ильхам кызы Гаджиева

Гаджиева Гюнель Ильхам кызы – старший лаборант кафедры хирургии полости рта и челюстно-лицевой области
Азербайджанского медицинского университета, Баку, Азербайджан.

References

1. WHO, Global registry and database on craniofacial anomalie, Report of a WHO
Registry Meeting on Craniofacial Anomalies, Craniofacial anomalies and 2 associated birth
defects, 2019
2. Tessier P, Rougier J, Wolfe SA. The craniofaciostenoses (CFS): the Crouzon and
Apert disease, the plagiocephalies. In: Masson (ed.), Plastic surgery of the orbits and eyelids,
200e223, 1981a. New York
3. Posnick JC, Ruiz RL. The craniofacial dysostosis syndromes: current surgical
thinking and future directions. Cleft Palate Craniofac J 37: 1e24, 2000
4. Adolphs N, Klein M, Haberl EJ, Menneking H, Hoffmeister B. Frontofacial advancement
by internal distraction devices. A technical modification for the management of craniofacial
dysostosis in early childhood. Int J Oral Maxillofac Surg 41: 777e782, 2012
5. Arnaud E, Di Rocco F. Faciocraniosynostosis: monobloc frontofacial osteotomy
replacing the two-stage strategy? Childs Nerv Syst 28: 1557e1564, 2012
6. Jackson IT, Munro IR, Salyer KE, Whitaker LA. Craniofacial dysostosis: late cranial
surgery (including forehead and vault). In: Mosby (ed), Atlas of craniomaxillofacial surgery,
499e542, 1982
7. Kamoshima Y, Sawamura Y, Yoshino M, Kawashima K. Frontofacial monobloc
advancement using gradual bone distraction method. J Pediatr Surg 43: 1944e 1948, 2008
8. Ko EWC, Chen PKT, Tai ICH, Huang CS. Fronto-facial monobloc distraction in syndromic
craniosynostosis. Three-dimensional evaluation of treatment outcome and facial
growth. Int J Oral Maxillofac Surg 41: 20e27, 2012
9. Nada RM, Sugar AW, Wijdeveld MGMM, Bortslap WA, Clauser L, Hoffmeister B et
al. Current practice of distraction osteogenesis for craniofacial anomalies in Europe: a web
based survey. J Craniomaxillofac Surg 38: 83e89, 2010
10. Nout E, Cesteleyn LLM, van der Wal KGH, van Adrichem LNA, Mathijssen IMJ,
Volvius EB. Advancement of the midface, from conventional Le Fort III osteotomy to the Le Fort
III distraction: review of the literature. Int J Oral Maxillofac Surg 37: 781e789, 2008
11. Guichard B, Davrou J, Neiva C, Devauchelle B. Midface osteotomies lines: evolution
by Paul Tessier, the second Tessier classification. J Craniomaxillofac Surg 41: 504e515, 2013
12. 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 61: 507e516, 1978
13. Gaur A, Maheshwari S, Kumar Verma S, Tariq M. Crouzon syndrome: A comprehensive
review and case report. Journal of Dr. NTR University of Health Sciences Volume 6
Issue 2 April-June 2017
14. Laure B, Moret A, Joly A, Travers N, Listrat A, Krastinova D, Goga D. Orbitofrontal
monobloc advancement for Crouzon syndrome. Journal of Cranio-Maxillo-Facial Surgery 42
(2014) e335ee338
15. Chim H, Wetjen N, Mardini S. Virtual Surgical Planning in Craniofacial Surgery.
Seminars in Plastic Surgery Vol. 28 No. 3/2014
16. McCarthy JG, Flores RL. Distraction of the midface: Le Fort III and monobloc.
Craniofacial distraction. pp 135-175. Springer International Publishing AG 2017
17. Rahimov C, Asadov R, Hajiyeva G, Verdiyev N, Novruzov Z, Farzaliyev I. Crouzon
syndrome: Virtual planning of surgical treatment by application of internal distractors. Ann
Maxillofac Surg 2016;6:135-40
18. Hlongwa P. Early orthodontic management of Crouzon Syndrome: a case report. J
Maxillofac Oral Surg 8 (1):74–76
19. Maspero C, Giannini L, Galbiati G, Kairyte L, Farronat G. Non surgical treatment
of Crouzon Syndrome. Stomatologija, Baltic Dental and Maxillofacial Journal, 16: 72–80,
2014.

Published

2019-12-16

Issue

Section

MAXILLOFACIAL SURGERY AND SURGICAL DENTISTRY