Apert's syndrome: modification in corrective techniques.

While the osteotomy techniques for craniofacial synostosis treatment are well-known and frequently used, the resolution of the nasal air impairment, ocular prolapse, and retromaxillism relapse remains unsatisfactory. The modification of the osteotomy presented here has the purpose of a new therapeutic trial.

Facial bone lengthening apparatus with expander and miniplates.

Since 1869, bone lengthening has been pursued; when Langenbeck tried growing a shortened bone extremity utilizing for this an arteriovenous fistula in the thigh. At the beginning of this century, codovilla (1905) introduced bone lengthening methods for lower limbs.

Histological and radioisotopical analysis of the skull graft: an experimental study in rabbits.

The purpose of this study was to develop an experimental model in rabbits that would permit us to analyze skull reconstruction and enable the study of bone autografts, osteofacial flaps, and other materials. We use the rabbit model to study the early integration of the skull autograft and to demonstrate the relationship between radioisotopical and histological analyses.

Trigonocephaly.

Trigonocephaly has been described either as an isolated anomaly or as part of the clinical spectrum of some well-known syndromes. Treatment, complications, and prognosis are closely related to the manifestations of the associated anomalies. We report on the main types of syndromes with trigonocephaly and the management of this condition.

Hypoglossia-hypodactyly syndrome in a Brazilian child: clinical and surgical aspects.

We describe a Brazilian child born with the hypoglossia-hypodactyly syndrome, complicated by bands joining the maxilla to the mandible. Clinical findings are presented, along with the surgical repair procedure.

[Growth stimulus of the paranasal sinuses with tissue expanders]. / Estímulo no crescimento dos seios paranasais com expansores teciduais.

Various congenital craniofacial deformities show hypoplastic paranasal sinus. The Treacher Collins, the Apert and Crouzon Syndromes and the Hemicraniofacial Microsomy, among others, are typical examples of this observation. Stimuli to the growth of the paranasal sinus during the facial growth period could sensibly improve the treatment of deformity, or even avoid later surgeries. Since their introduction in plastic surgery, tissue expanders are progressively acquiring greater importance in many areas of the specialty. This is a safe and simple alternative to solve difficult cases. It has been demonstrated that real tissue growth occurred in all layers of cutaneous tissues subjected to expansion, including the induction of mitoses. Recent works showed that microorbits could be corrected through the introduction of expanders in their orbits. The authors proposed that to stimulate the growth of paranasal sinus, tissue expanders should be introduced bilaterally in the maxillar, frontal, ethmoidal and sphenoidal sinus, which should promote the development of the face. The expansion induced should be controlled and gradual through injections of small amounts of saline in each session. This project includes the cautious design of the size and shape of the expanders as well as the care with adequate draining of the sinusal cavity and the possible mechanical atrophy of the mucosal lining of the sinus.

Craniofacial fibrous dysplasia.

This article describes a 20-year-old man with widespread polyostotic fibrous dysplasia that resulted in massive craniofacial deformity with unilateral exorbitism and oronasal obstruction. The patient illustrates the rare occurrence of fibrous dysplasia with major malformation of the face and skull, requiring multiple stages of surgical "sculpture" to improve function and appearance. The disease entity, differential diagnosis, and treatment are discussed.

Repair of large defect of frontal bone with free graft of outer table of parietal bones.

We present a case with a full-thickness bony defect in the frontal area. It was corrected successfully by a free bone graft to the outer table from the parieto-occipital area, partly covered by a flap of periosteum from the same area.