Craniofacial Surgery 9

Proceedings of the Ninth International Congress of the International Society of Craniofacial Surgery

Visby, Gotland, Sweden, 2001


Monduzzi Editore International Proceedings Division Home Page



It was very rainy. But there were surgeons and craniofacial teammates from 37 countries gathering in Visby on the island of Gotland in the Baltic Sea to get together to present, discuss and listen to new developments in craniofacial surgery.

The biennial congress arranged by the president of the International Society of Craniofacial Surgery has matured into becoming the one event the active craniofacial surgeon must attend. This is where new ideas are presented. This is where serious warnings can be heard. This is where you have to be. This meeting is now an institution.

It has been an overwhelming honor to be elected the president of this group of probably some of the best surgeons in the world. So what does that make me? – It makes me grateful and humble. It also brings very vividly to my mind the start, when my mentor and chief Bengt Johanson urged me to plunge into this new field of surgery. Bengt´s deep friendship with Paul Tessier gave him a direct insight in what was going on and Bengt saw the possibilities and he created the craniofacial unit at the Sahlgrenska Hospital in Göteborg. We worked very hard. Bengt was determined to shape me into a surgeon who could indulge in this new field of reconstructive surgery and he gave me all the support I needed. Bengt has since he retired from active surgery been my most foremost supporter. Bengt is one of the giants in plastic surgery. His support for me personally is however not at all just about me, it is much more about my persuing the fine art of craniofacial surgery, that he brought to Sweden. He had a vision and he has been fortunate enough to see it become reality. By the ISCFS having its first biennial meeting of the new millennium in Sweden, Bengt knows his tuition and mentorship was not in vain.

In looking back I can not omit to mention Ian Munro, my boss 1981-82 and who is now sailing the oceans on his catamaran. Ian taught me that "survival of the fittest" was rule number one in the OR. He was adamant that speed was essential in surgery and I agree. I owe Ian a great deal. Speed is essential because operative time must me reduced in order to have saved enough energy for the final touches that are so essential in craniofacial surgery. Thank you Ian.

In my invitation to this congress I set the theme "smaller surgery" and several examples of innovations along that theme were presented. Some of these can be reviewed in this book. No doubt tissue distraction is essential in context. Tissue distraction does not mean bone elongation only. Our own work with implantable springs gradually reshaping skulls certainly is not DOG (distraction osteoneogenesis) but has opened new avenues of accomplishing big surgery with minimal means, if you will. Springs in craniofacial surgery did attract considerable attention during the meeting and we expect to see much more of this in the future.

Impressive research results were also presented indicating among many other interesting things that the cause of premature synostoses can be looked for in the chemistry of the dura mater underneath the synostosed suture.

In this book many of the best contributions from the Visby meeting are presented, for you to bring to the armchair or to think about when you go to bed. Do it! Go on, elaborate on these ideas. Let us hear about what you have come up with next time in 2003 when we meet again.

Göteborg in October 2001

Claes Lauritzen





A Model for the Development and Delivery of Craniofacial Health Care Systems in Developing Countries
D.J. David


Chapter I


Orbival Volume in Craniosynostosis
R. Bentley, S. Sgouros, K. Natarajan, H. Nishikawa, S. Dover and A. Hockley

The Application of Intraoperative Anthropometry in the Assessment and Surgical Correction of Craniosynostotic Deformities
R. Burvin, G. Rogers, M. Proctor and J. Mulliken

Strip Craniectomy for Scaphocephaly. A Long Term Follow-up

Presence of Orbital Dystopia in Unicoronal Synostosis
K. Dickinson, J. Neil-Dwyer, K. Chong and K.K. Nischal

The Use of Recombinant Erythropoietin in the Reduction of Blood Transfusion Rates in Craniosynostosis Repair in Infants and Children
J.A. Fearon and J. Weinthal

Comparison of Bioresorbable Versus Titanium Fixation in Pediatric Craniosynostosis Surgery
C. Forrest, D. Grace, J. Rutka, J. Drake, P. Dirks and R. Humphreys

Oblique Vertical Optokinetic Nystagmus in Patients with Craniosynostosis _ A New Finding
S. Garbutt, K.K. Nischal1, F. Barampouti1, W. Aclimandos and B.M. Jones

Scaphocephaly and Mental Development _ Outcome of Pi-procedure

What Is the Natural History of Raised Intracranial Pressure Complicating Syndromic Craniosynostosis?
R. Hayward, K. Nischal, D. Thompson, D. Dunaway, R. Evans and B. Jones

Distraction for Cranial Remodeling in Craniosynostosis; New Divice and Osteotomy Line

Documentation of Craniosynostosis Using a Standardized Protocol
T.H. Jünger, T. Posselt, D. Steinberger, H. Collmann, B. Kotrikova,
J. Zöller and H.-P. Howaldt

Assessment of Postoperative Cranial Vault Growth In Syndromal Synostoses
J.C. Kolar, K.E. Salyer and A. Yamada

Problems with Secondary Corrections for Craniosynostosis in Adolescents
D. Marchac, D. Renier and E. Arnaud

Preliminary Resultw and New Treatment Protocol for Cranial Banding Following Endoscopic-Assisted Craniectomy for Sagittal Synostosis
J.K. Pomatto, S.P. Beals, E.F. Joganic, S.D. Moss, K.M. Kelly and T.R. Littlefield

Intracranial Remodeling for Syndromal Craniosynostosis: 12 Year Experience
K.E. Salyer, J.C. Kolar, A. Yamada, D.G. Genecov, D.A. Bruce and K. Shapiro

Combined Sagittal and Bilambdoid Synostosis _ Craniodyssynostosis to Mercedes Benz Syndrome
J.M. Vaandrager and R.R.W.J. van der Hulst

Chapter II

Research and diagnostics

Haptic Exploration and Modeling in the Planning of Craniofacial Reconstruction
O. Antonyshyn and T. McInerney

Long Term Developmental Outcome in Children with Deformational Plagiocephaly
L. Argenta, L. David, D. Goldstein and P. Kilgo

Force Induced Craniosynostosis Produces Factors that Affect Suture Morphogenesis
S. Buchman, S. Rhee, M. Ignelzi, J. Tabaos and S. Goldstein

Regional Dura Mater Differentially Regulates Osteoblast Gene Expression in an In Vitro Co-culture Model
F. Crisera, S. Warren, J. Greenwald, J. Spector, Z. Peled, P. Bouletreau and M. Longaker

In Vitro "Cleft Palate" Model with Mesenchymal Rescue
S. Erfani, C. Crisera, T. Maldonado, S. Warren, P. Bouletreau, Z. Peled and M. Longaker

Immavure Dura Mater Paracrine Signaling Increases Osteoblast Proliferation and Dif-ferentiation
P. Fagenholz, J. Spector, J. Greenwald, S. Warren, R. Detch, B. Mehrara and M. Longaker

Norian CRS Compatibility with Bioresorbable Plating Materials _ An Animal Model, An Interim Report
D. Genecov, M. Kremer, L. Opperman, R. Agarwal and K. Salyer

Regional Dura Mater Determines Fate of Overlying Cranial Suture
J. Greenwald, B. Mehrara, J. Spector, S. Warren, F. Crisera, P. Fagenholz, P. Bouletreau and M. Longaker

In Vivo Modification of FGF-biologic Activity Alters Cranial Suture Fate
M. Longaker, J. Greenwald, B. Mehrara, J. Spector, S. Warren, P. Fagenholz, L. Smith, P. Bouletreau, F. Crisera and H. Ueno

Understanding the Molecular Mechanisms Governing Distraction Osteogenesis
B. Mehrara, S. Warren, P. Bouletreau, M. Paccione and M. Longaker

Development of Cytoprotective Strategies for the Prevention of Radiation Induced Craniofacial Bone Growth Inhibition in an Infant Rabbit Model
D. O'Donovan, G. LeScala, I. Yeung, V. Zeman, M. Mendes, I. Leong, K.P.H. Pritzker, C.Y. Pang, P. Neligan and C.R. Forrest

Endogenous Cytokine Levels As a Function of Gestational Age in Fetal Rat Fibroblasts: Implications for Scarless Cleft Lip/Palate Repair
Z. Peled, G. Chin, M. Hsu, W. Liu, H. Levinson, S. Lee and M. Longaker

Reconstruction of Craniofacial Defects with Bone-Marrow-Coated Polycaprolactone Scaffolds
D. Rohner, D.W. Hutmacher, P. See, K.C. Tan, V. Yeow, S.Y. Tan, S.T. Lee and B. Hammer

A Novel Model of Mouse Mandibular Osteotomy Healing
P. Saadeh, M. Paccione, S. Warren, P. Bouletreau and M. Longaker

Psychological Functioning of Adolescents Born with Craniofacial Anomalies
D. Sarwer, L. Whitaker and S. Bartlett

The Autocrine and Paracrine Effects of FGF-2 on Dura Mater: Implications for Calvarial Growth and Re-ossification
L. Smith, J. Spector, J. Greenwald, S. Warren, P. Bouletreau, R. Detch, P. Fagenholz, F. Crisera and M. Longaker

Effects of FGF-2 on Osteoblast BMP-2 Expression: Implications for Mechanism of FGF Receptor-Mediated Craniosynostosis
J. Spector, S. Warren, J. Greenwald, S. Erfani, P. Bouletreau, F. Crisera and M. Longaker

Noggin Expression Maintains Cranial Suture Patency
S. Warren, J. Greenwald, P. Bouletreau, J. Spector, R. Harland and M. Longaker

The Role of Twinning in the Aetiology of Hemifacial Microsomia
N. Waterhouse

The Identification of Calcium Oscillators in Immature Rat Cranial Sutures
J.C. Yu, J.P. Braselton, M.L. Abell and J.L. Borke


Chapter III

Tissue distraction

Bifocal Distraction Osteogenesis: A New Method to Heal Adult Calvarial Defects
P. Bouletreau, S. Warren, M. Paccione, J. Spector, J. McCarthy and M. Longaker

Internal Craniofacial Distraction with Biodegradable Devices
S.R. Cohen and R.E. Holmes

Dynaoic Spring Mediated Cranioplasty in a Rabbit Model
L. David, J. Guimaraes-Ferreira, F. Gewalli, C. Sanger and L. Argenta

Distraction of the Orbit in a Tessier IV Facial Cleft: Case Report
R. Giuliani, A. Bianchi, F. Neri and E. Galliani

Controlled Bone Regeneration in Distraction Osteogenesis
M.B. Habal

Correction of Plagiocephaly by Distraction Osteogenesis with Floating Bone Flap

Three Years Experience with Implantable Springs in Craniofacial Surgery
C. Lauritzen, J. Guimarães-Ferreira, F. Gewalli, R. Olsson, L. David and P. Tarnow

Craniofacial Distraction Osteogenesis: A Review of 3,278 Cases
M. Mofid, P. Manson, B. Robertson, A. Tufaro, J. Elias and C. Vander Kolk

Latency, Rate, and Rhythm Determine the Adaptive Response in a Rat Model of Mandibular Distraction Osteogenesis
M. Paccione, S. Warren, B. Mehrara, P. Bouletreau and M. Longaker

Experience with a New FDA Approved Cranial Orthosis: The CranioCap
R.J. Wood, E.T. Elwood and J.A. Petronio


Chapter IV

Orthognathic surgery

"Cat's Cradle" Midfacial Fixation in Distraction Osteogenesis following LeFort III Osteotomy
R.J. Havlik and R. Hathaway

Semi-rigid Internal Distraction Device for the LeFort III Advancement: A Case Report
Y. Imai, A. Yamada and Y. Sugawara

A Seven-Year Expermence of Thirty-two Consecutive Transcranial Mid-facial Osteotomies
B.M. Jones, J. Neil-Dwyer, R. Evans, D. Dunaway and R. Hayward

Management of Mandibular Condyle Fracture (Closed versus Open Approach)
A. Kazemi and A. Tavassoli-Ashrafi

Segmental Osteogenic Distraction in Cleft Palate Maxillary Retrusions
L.A. Margaride, J. Breuer and H. Sala

In Case of Microsomia _ Conventional Method vs. Distractive Surgery
K. Ohmori

Endoscopically Assisted Le Fort I Osteotomy
D. Rohner, V. Yeow and B. Hammer

Post-traumatic Malocclusion
N. Strumas, S. Smith, O. Antonyshyn, J. Fialkov and C. Forrest


Chapter V


Nasal Reconstruction in Hypertelorism _ The Problem of Blood Supply
F. Ortiz Monasterio and F. Molina

Diplopia Following Craniofacial Reconstruction for Hypertelorism Correction


Chapter VI

Tumours and facial reconstruction

Nasal Reconstruction of Complex Facial Clefts. Age Versus Type of Reconstruction
N. Alonso, R. Freitas and D. Goldenberg

Reconstruction of Lateral Nasal Proboscis with Heminasal Aplasia _ A Case Report
S. Beals

Optic Nerve Decompression During Surgery For Frontal, Ethmoidal, Orbital or Maxillary Fibrous Dysplasia
D. Bruce, J. Fearon, K. Salyer, K. Shapiro and D. Swift

Use of Hydroxyapatite (HA) Cement in Reconstruction of Complex Congenital and Acquired Cranial Vault Deformities
M. Cohen, R. Humphreys, P. Dirks, J. Rutka, J. Drake and C. Forrest

Outcome Following Early Surgical Intervention in the Treatment of Pediatric Orbital Floor Trapdoor Fractures
C. Forrest, N. de Kleer, S. Blaser and R. Buncic

Lacrimal Gland Adenosquamous Carcinoma: An Unusual Case of Proptosis in a 6 Year Old Boy
C. Forrest, A. Mihailovic, R. Buncic, J. Drake, J. Thorner and M. Greenberg

A One Year Study of Hydroxyapatite Derivatives in Reconstruction of Cranial Defects: Bioengineering Implants to Optimize Bone Replacement
A.K. Gosain, L. Song, P. Riordan, M.T. Amarante, B. Kalantarian, P.G. Nagy, C.R. Wilson, J.M. Toth, L.C. Chow and B. McIntyre

Reconstruction of Complex Orbito-Cranial Deformities: The Role of Bioresorbable Mesh
R.E. Holmes, S.R. Cohen, H.K. Meltzer and D.O. Kikkawa

A One Year Study of Hydroxyapatite Derivatives in Facial Skeletal Augmentation: Autogenous Bone Graft Versus Biomaterials to Depository Versus Resorptive Recipient Sites
B. Kalantarian, L. Song, P.A. Riordan, M.T. Amarante, P.G. Nagy, C. R. Wilson, J.M. Toth, L.C. Chow, B.L. McIntyre and A.K. Gosain

Simultaneous Surgical Treatment of Anterior Skull Base Fracture and Associated FrontoOrbital Fractures
A. Kazemi and A. Tavassoli_Ashrafi

Vascularized Frontal Outer Table Flap for the Anterior Skull Base Tumor Resection
S. Kyutoku, K. Kawakami, H. Tsuji, M. Kyutoku-Tsujita, A.Tanabe and M. Hihara

Anterior Cranial Base Fibrous Dysplasia and the Effect on the Optic Nerve Canal and Vision
J.S. Lee, E. FitzGibbon, J.A. Butman, C.R. Dufresne, S. Wientroub, P.G. Robey and M.T. Collins

An Alternative Dissection Plane for Endoscopic Assisted Comminuted Malar Fracture Repair
S.-S. Lee, S.-D. Lin, Y.-T. Chiu, C.-C. Tsai, T.-M. Lin and K.-P. Chang

The Rugose Nose: Clinical and Surgical Considerations
I. Mathijssen and M. Vaandrager

Versatile Peri-orbital Osteotomies with or without Local Flap Transfer and Midface Distraction
X. Mu and T. Chang

Eyebrow Reconstruction

Multimodality Imaging for Precise Localization of Craniofacial Osteomyelitis
N. Strumas, O. Antonyshyn, C. Caldwell and J. Mainprize

Nasal Tip Hemangiomas: A New Subunit Approach
B. Zide, S. Warren and M. Longake

 Via Maserati 5 Bologna Italy   - Tel. +39 051 4151123   Fax +39 051 370529