Application and development of orthognathic surgery in treatment of syndromic craniosynostosis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHAO Chenjie ,  TENG Li

The Second Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, P. R. China;

Corresponding author：

TENG Li, Email: tenglidr@sina.com

Keywords：

Syndromic craniosynostosis; orthognathic surgery; Le Fort I osteotomy; sagittal split ramus osteotomy

DOI：

10.7507/1002-1892.202302102

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the application and recent development of orthognathic surgery in treating syndromic craniosynostosis. Methods The related literature at home and abroad in recent years was extensively reviewed, and the indications, routine procedures, and protocols of orthognathic surgery in the treatment of syndromic craniosynostosis were summarized and analyzed. Results Craniosynostosis is a common congenital craniofacial malformation. Syndromic craniosynostosis usually involves premature fusion of multiple cranial sutures and is associated with other deformities. Orthognathic surgery is the necessary and effective means to improve the midfacial hypoplasia and malocclusion. Le Fort I osteotomy combined with sagittal split ramus osteotomy are the common surgical options. Orthognathic surgery should combine with craniofacial surgery and neurosurgery, and a comprehensive long-term evaluation should be conducted to determine the best treatment plan. Conclusion Orthognathic surgery plays an important role in the comprehensive diagnosis and treatment of syndromic craniosynostosis. The development of digital technology will further promote the application and development of orthognathic surgery in the treatment of syndromic craniosynostosis.

Citation： ZHAO Chenjie, TENG Li. Application and development of orthognathic surgery in treatment of syndromic craniosynostosis. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(7): 879-884. doi: 10.7507/1002-1892.202302102 Copy

1.	Öwall L, Kreiborg S, Dunø M, et al. Phenotypic variability in Muenke syndrome-observations from five Danish families. Clin Dysmorphol, 2020, 29(1): 1-9.
2.	Taylor JA, Bartlett SP. What’s new in syndromic craniosynostosis surgery? Plast Reconstr Surg, 2017, 140(1): 82e-93e.
3.	Kutkowska-Kaźmierczak A, Gos M, Obersztyn E. Craniosynostosis as a clinical and diagnostic problem: molecular pathology and genetic counseling. J Appl Genet, 2018, 59(2): 133-147.
4.	Akai T, Yamashita M, Shiro T, et al. Long-term outcomes of non-syndromic and syndromic craniosynostosis: analysis of demographic, morphologic, and surgical factors. Neurol Med Chir (Tokyo), 2022, 62(2): 57-64.
5.	Kobayashi Y, Ogura K, Hikita R, et al. Craniofacial, oral, and cervical morphological characteristics in Japanese patients with Apert syndrome or Crouzon syndrome. Eur J Orthod, 2021, 43(1): 36-44.
6.	Ferri J, Schlund M, Touzet-Roumazeille S. Orthognathic surgery in craniosynostosis. J Craniofac Surg, 2021, 32(1): 141-148.
7.	Pelc A, Mikulewicz M. Saethre-Chotzen syndrome: Case report and literature review. Dent Med Probl, 2018, 55(2): 217-225.
8.	Pagnoni M, Fadda MT, Spalice A, et al. Surgical timing of craniosynostosis: what to do and when. J Craniomaxillofac Surg, 2014, 42(5): 513-519.
9.	Posnick JC, Ruiz RL. The craniofacial dysostosis syndromes: current surgical thinking and future directions. Cleft Palate Craniofac J, 2000, 37(5): 433. doi: 10.1597/1545-1569(2000)037<0433:TCDSCS>2.0.CO;2.
10.	Joly A, Croise B, Travers N, et al. Management of isolated and complex craniosynostosis residual deformities: What are the maxillofacial tools? Neurochirurgie, 2019, 65(5): 295-301.
11.	Silvola AS, Rusanen J, Tolvanen M, et al. Occlusal characteristics and quality of life before and after treatment of severe malocclusion. Eur J Orthod, 2012, 34(6): 704-709.
12.	Massenburg BB, Susarla SM, Kapadia HP, et al. Subcranial midface advancement in patients with syndromic craniosynostosis. Oral Maxillofac Surg Clin North Am, 2022, 34(3): 467-475.
13.	Bastidas N, Mackay DDJ, Taylor JA, et al. Analysis of the long-term outcomes of nonsyndromic bicoronal synostosis. Plast Reconstr Surg, 2012, 130(4): 877-883.
14.	Nout E, Koudstaal MJ, Wolvius EB, et al. Additional orthognathic surgery following Le Fort Ⅲ and monobloc advancement. Int J Oral Maxillofac Surg, 2011, 40(7): 679-684.
15.	Azoulay-Avinoam S, Bruun R, MacLaine J, et al. An overview of craniosynostosis craniofacial syndromes for combined orthodontic and surgical management. Oral Maxillofac Surg Clin North Am, 2020, 32(2): 233-247.
16.	Arnaud E, Paternoster G, James S, et al. Craniofacial strategy for syndromic craniosynostosis. Annales De Chirurgie Plastique Et Esthetique, 2016, 61(5): 408-419.
17.	Yang J, Lei J, Wu Y, et al. Skeleton first in surgical treatment of facial disharmony. J Craniofac Surg, 2015, 26(2): 336-339.
18.	Nurko C, Quinones R. Dental and orthodontic management of patients with Apert and Crouzon syndromes. Oral Maxillofac Surg Clin North Am, 2004, 16(4): 541-553.
19.	Sawh-Martinez R, Steinbacher DM. Syndromic craniosynostosis. Clin Plast Surg, 2019, 46(2): 141-155.
20.	Allareddy V. Orthognathic surgeries in patients with congenital craniofacial anomalies: profile and hospitalization outcomes. Cleft Palate Craniofac J, 2015, 52(6): 698-705.
21.	Chow LK, Singh B, Chiu WK, et al. Prevalence of postoperative complications after orthognathic surgery: a 15-year review. J Oral Maxillofac Surg, 2007, 65(5): 984-992.
22.	Hopper RA, Kapadia H, Susarla SM. Surgical-orthodontic considerations in subcranial and frontofacial distraction. Oral Maxillofac Surg Clin North Am, 2020, 32(2): 309-320.
23.	Yang IH, Chung JH, Lee HJ, et al. Characterization of treatment modalities for patients with syndromic craniosynostosis in relation to degree of midface hypoplasia and patient’s age using longitudinal follow-up data. J Craniofac Surg, 2022, 33(5): 1469-1473.
24.	Raffaini M, Magri AS, Genitori L, et al. Algorithm to the treatment of Crouzon syndrome. J Craniomaxillofac Surg, 2022, 50(2): 124-133.
25.	Kahnberg KE, Hagberg C. Orthognathic surgery in patients with craniofacial syndrome. Ⅰ. A 5-year overview of combined orthodontic and surgical correction. J Plast Surg Hand Surg, 2010, 44(6): 282-288.
26.	Lakin GE, Kawamoto HK Jr. Le Fort Ⅱ osteotomy. J Craniofac Surg, 2012, 23(7 Suppl 1): 1964-1967.
27.	Han JT, Egbert MA, Ettinger RE, et al. Orthognathic surgery in patients with syndromic craniosynostosis. Oral Maxillofac Surg Clin North Am, 2022, 34(3): 477-487.
28.	Yang R, Shakoori P, Lanni MA, et al. Influence of monobloc/Le Fort Ⅲ surgery on the developing posterior maxillary dentition and its resultant effect on orthognathic surgery. Plast Reconstr Surg, 2021, 147(2): 253e-259e.
29.	Sancar B, Tanisik BH. Treatment of the patient with Crouzon Syndrome with orthognathic surgery. J Craniofac Surg, 2020, 31(3): 806-808.
30.	Tessier P. The definitive plastic surgical treatment of the severe facial deformities of craniofacial dysostosis. Crouzon’s and Apert’s diseases. Plast Reconstr Surg, 1971, 48(5): 419-442.
31.	Chin M, Toth BA. Le Fort Ⅲ advancement with gradual distraction using internal devices. Plast Reconstr Surg, 1997, 100(4): 819-830.
32.	Tahiri Y, Taylor J. An update on midface advancement using Le Fort Ⅱ and Ⅲ distraction osteogenesis. Semin Plast Surg, 2014, 28(4): 184-192.
33.	Min Swe NM, Kobayashi Y, Kamimoto H, et al. Aberrantly activated Wnt/β-catenin pathway co-receptors LRP5 and LRP6 regulate osteoblast differentiation in the developing coronal sutures of an Apert syndrome (Fgfr2S252W/+) mouse model. Dev Dyn, 2021, 250(3): 465-476.
34.	Hopper RA, Wang HD, Mercan E. Le Fort Ⅱ distraction with simultaneous zygomatic repositioning. Clin Plast Surg, 2021, 48(3): 487-496.
35.	Liu MT, Kurnik NM, Mercan E, et al. Magnitude of horizontal advancement is associated with apnea hypopnea index improvement and counter-clockwise maxillary rotation after subcranial distraction for syndromic synostosis. J Oral Maxillofac Surg, 2021, 79(5): 1133.e1-1133.e16.
36.	Hopper RA, Kapadia H, Susarla SM. Le Fort Ⅱ distraction with zygomatic repositioning: a technique for differential correction of midface hypoplasia. J Oral Maxillofac Surg, 2018, 76(9): 2002.e1-2002.e14.
37.	McGrath J, Gerety PA, Derderian CA, et al. Differential closure of the spheno-occipital synchondrosis in syndromic craniosynostosis. Plast Reconstr Surg, 2012, 130(5): 681e-689e.
38.	Burdi AR, Kusnetz AB, Venes JL, et al. The natural history and pathogenesis of the cranial coronal ring articulations: implications in understanding the pathogenesis of the Crouzon craniostenotic defects. Cleft Palate J, 1986, 23(1): 28-39.
39.	Meazzini MC, Corradi F, Mazzoleni F, et al. Circummaxillary sutures in patients with Apert, Crouzon, and Pfeiffer syndromes compared to nonsyndromic children: growth, orthodontic, and surgical implications. Cleft Palate Craniofac J, 2021, 58(3): 299-305.
40.	Forte AJ, Alonso N, Persing JA, et al. Analysis of midface retrusion in Crouzon and Apert syndromes. Plast Reconstr Surg, 2014, 134(2): 285-293.
41.	Resnick CM, Kim S, Yorlets RR, et al. Evaluation of Andrews’ analysis as a predictor of ideal sagittal maxillary positioning in orthognathic surgery. J Oral Maxillofac Surg, 2018, 76(10): 2169-2176.
42.	Susarla SM, Ettinger RE, Egbert MA. Transmucosal pterygomaxillary separation in the Le Fort Ⅰ osteotomy. Plast Reconstr Surg, 2020, 145(5): 1262-1265.
43.	Hopper RA, Sandercoe G, Woo A, et al. Computed tomographic analysis of temporal maxillary stability and pterygomaxillary generate formation following pediatric Le Fort Ⅲ distraction advancement. Plast Reconstr Surg, 2010, 126(5): 1665-1674.
44.	Susarla SM, Ettinger R, Preston K, et al. Technical modifications specific to the cleft Le Fort Ⅰ osteotomy. J Craniofac Surg, 2020, 31(5): 1459-1463.
45.	Reitsma JH, Ongkosuwito EM, Buschang PH, et al. Facial growth in patients with apert and crouzon syndromes compared to normal children. Cleft Palate Craniofac J, 2012, 49(2): 185-193.
46.	Zhou X, Pu D, Liu R, et al. The Fgfr2(S252W/+) mutation in mice retards mandible formation and reduces bone mass as in human Apert syndrome. Am J Med Genet A, 2013, 161A(5): 983-992.
47.	Kreiborg S. Crouzon Syndrome. A clinical and roentgencephalometric study. Scand J Plast Reconstr Surg Suppl, 1981, 18: 1-198.
48.	Wink JD, Bastidas N, Bartlett SP. Analysis of the long-term growth of the mandible in Apert syndrome. J Craniofac Surg, 2013, 24(4): 1408-1410.
49.	Costaras-Volarich M, Pruzansky S. Is the mandible intrinsically different in Apert and Crouzon syndromes? Am J Orthod, 1984, 85(6): 475-487.
50.	Reitsma JH, Elmi P, Ongkosuwito EM, et al. A longitudinal study of dental arch morphology in children with the syndrome of Crouzon or Apert. Eur J Oral Sci, 2013, 121(4): 319-327.
51.	Agochukwu NB, Solomon BD, Doherty ES, et al. Palatal and oral manifestations of Muenke syndrome (FGFR3-related craniosynostosis). J Craniofac Surg, 2012, 23(3): 664-668.
52.	Posnick JC, Choi E, Liu S. Occurrence of a “bad” split and success of initial mandibular healing: a review of 524 sagittal ramus osteotomies in 262 patients. Int J Oral Maxillofac Surg, 2016, 45(10): 1187-1194.
53.	Susarla SM, Cho DY, Ettinger RE, et al. The low medial horizontal osteotomy in patients with atypical ramus morphology undergoing sagittal split osteotomy. J Oral Maxillofac Surg, 2020, 78(10): 1813-1819.
54.	Wenger TL, Hopper RA, Rosen A, et al. A genotype-specific surgical approach for patients with Pfeiffer syndrome due to W290C pathogenic variant in FGFR2 is associated with improved developmental outcomes and reduced mortality. Genet Med, 2019, 21(2): 471-476.
55.	Doerga PN, Spruijt B, Mathijssen IM, et al. Upper airway endoscopy to optimize obstructive sleep apnea treatment in Apert and Crouzon syndromes. J Craniomaxillofac Surg, 2016, 44(2): 191-196.
56.	Al-Namnam NMN, Hariri F, Rahman ZAA. Distraction osteogenesis in the surgical management of syndromic craniosynostosis: a comprehensive review of published papers. Br J Oral Maxillofac Surg, 2018, 56(5): 353-366.
57.	Kim BJ, Bae HS, Lee Y. One-stage treatment for adult patients with crouzonoid appearance by orthognathic and face contouring surgery. J Craniofac Surg, 2017, 28(5): e441-e444.
58.	Vyas K, Gibreel W, Mardini S. Virtual surgical planning (VSP) in craniomaxillofacial reconstruction. Facial Plast Surg Clin North Am, 2022, 30(2): 239-253.
59.	Dumas BM, Nava A, Law HZ, et al. Three-dimensional printing for craniofacial surgery: a single institution’s 5-year experience. Cleft Palate Craniofac J, 2019, 56(6): 729-734.

1. Öwall L, Kreiborg S, Dunø M, et al. Phenotypic variability in Muenke syndrome-observations from five Danish families. Clin Dysmorphol, 2020, 29(1): 1-9.
2. Taylor JA, Bartlett SP. What’s new in syndromic craniosynostosis surgery? Plast Reconstr Surg, 2017, 140(1): 82e-93e.
3. Kutkowska-Kaźmierczak A, Gos M, Obersztyn E. Craniosynostosis as a clinical and diagnostic problem: molecular pathology and genetic counseling. J Appl Genet, 2018, 59(2): 133-147.
4. Akai T, Yamashita M, Shiro T, et al. Long-term outcomes of non-syndromic and syndromic craniosynostosis: analysis of demographic, morphologic, and surgical factors. Neurol Med Chir (Tokyo), 2022, 62(2): 57-64.
5. Kobayashi Y, Ogura K, Hikita R, et al. Craniofacial, oral, and cervical morphological characteristics in Japanese patients with Apert syndrome or Crouzon syndrome. Eur J Orthod, 2021, 43(1): 36-44.
6. Ferri J, Schlund M, Touzet-Roumazeille S. Orthognathic surgery in craniosynostosis. J Craniofac Surg, 2021, 32(1): 141-148.
7. Pelc A, Mikulewicz M. Saethre-Chotzen syndrome: Case report and literature review. Dent Med Probl, 2018, 55(2): 217-225.
8. Pagnoni M, Fadda MT, Spalice A, et al. Surgical timing of craniosynostosis: what to do and when. J Craniomaxillofac Surg, 2014, 42(5): 513-519.
9. Posnick JC, Ruiz RL. The craniofacial dysostosis syndromes: current surgical thinking and future directions. Cleft Palate Craniofac J, 2000, 37(5): 433. doi: 10.1597/1545-1569(2000)037<0433:TCDSCS>2.0.CO;2.
10. Joly A, Croise B, Travers N, et al. Management of isolated and complex craniosynostosis residual deformities: What are the maxillofacial tools? Neurochirurgie, 2019, 65(5): 295-301.
11. Silvola AS, Rusanen J, Tolvanen M, et al. Occlusal characteristics and quality of life before and after treatment of severe malocclusion. Eur J Orthod, 2012, 34(6): 704-709.
12. Massenburg BB, Susarla SM, Kapadia HP, et al. Subcranial midface advancement in patients with syndromic craniosynostosis. Oral Maxillofac Surg Clin North Am, 2022, 34(3): 467-475.
13. Bastidas N, Mackay DDJ, Taylor JA, et al. Analysis of the long-term outcomes of nonsyndromic bicoronal synostosis. Plast Reconstr Surg, 2012, 130(4): 877-883.
14. Nout E, Koudstaal MJ, Wolvius EB, et al. Additional orthognathic surgery following Le Fort Ⅲ and monobloc advancement. Int J Oral Maxillofac Surg, 2011, 40(7): 679-684.
15. Azoulay-Avinoam S, Bruun R, MacLaine J, et al. An overview of craniosynostosis craniofacial syndromes for combined orthodontic and surgical management. Oral Maxillofac Surg Clin North Am, 2020, 32(2): 233-247.
16. Arnaud E, Paternoster G, James S, et al. Craniofacial strategy for syndromic craniosynostosis. Annales De Chirurgie Plastique Et Esthetique, 2016, 61(5): 408-419.
17. Yang J, Lei J, Wu Y, et al. Skeleton first in surgical treatment of facial disharmony. J Craniofac Surg, 2015, 26(2): 336-339.
18. Nurko C, Quinones R. Dental and orthodontic management of patients with Apert and Crouzon syndromes. Oral Maxillofac Surg Clin North Am, 2004, 16(4): 541-553.
19. Sawh-Martinez R, Steinbacher DM. Syndromic craniosynostosis. Clin Plast Surg, 2019, 46(2): 141-155.
20. Allareddy V. Orthognathic surgeries in patients with congenital craniofacial anomalies: profile and hospitalization outcomes. Cleft Palate Craniofac J, 2015, 52(6): 698-705.
21. Chow LK, Singh B, Chiu WK, et al. Prevalence of postoperative complications after orthognathic surgery: a 15-year review. J Oral Maxillofac Surg, 2007, 65(5): 984-992.
22. Hopper RA, Kapadia H, Susarla SM. Surgical-orthodontic considerations in subcranial and frontofacial distraction. Oral Maxillofac Surg Clin North Am, 2020, 32(2): 309-320.
23. Yang IH, Chung JH, Lee HJ, et al. Characterization of treatment modalities for patients with syndromic craniosynostosis in relation to degree of midface hypoplasia and patient’s age using longitudinal follow-up data. J Craniofac Surg, 2022, 33(5): 1469-1473.
24. Raffaini M, Magri AS, Genitori L, et al. Algorithm to the treatment of Crouzon syndrome. J Craniomaxillofac Surg, 2022, 50(2): 124-133.
25. Kahnberg KE, Hagberg C. Orthognathic surgery in patients with craniofacial syndrome. Ⅰ. A 5-year overview of combined orthodontic and surgical correction. J Plast Surg Hand Surg, 2010, 44(6): 282-288.
26. Lakin GE, Kawamoto HK Jr. Le Fort Ⅱ osteotomy. J Craniofac Surg, 2012, 23(7 Suppl 1): 1964-1967.
27. Han JT, Egbert MA, Ettinger RE, et al. Orthognathic surgery in patients with syndromic craniosynostosis. Oral Maxillofac Surg Clin North Am, 2022, 34(3): 477-487.
28. Yang R, Shakoori P, Lanni MA, et al. Influence of monobloc/Le Fort Ⅲ surgery on the developing posterior maxillary dentition and its resultant effect on orthognathic surgery. Plast Reconstr Surg, 2021, 147(2): 253e-259e.
29. Sancar B, Tanisik BH. Treatment of the patient with Crouzon Syndrome with orthognathic surgery. J Craniofac Surg, 2020, 31(3): 806-808.
30. Tessier P. The definitive plastic surgical treatment of the severe facial deformities of craniofacial dysostosis. Crouzon’s and Apert’s diseases. Plast Reconstr Surg, 1971, 48(5): 419-442.
31. Chin M, Toth BA. Le Fort Ⅲ advancement with gradual distraction using internal devices. Plast Reconstr Surg, 1997, 100(4): 819-830.
32. Tahiri Y, Taylor J. An update on midface advancement using Le Fort Ⅱ and Ⅲ distraction osteogenesis. Semin Plast Surg, 2014, 28(4): 184-192.
33. Min Swe NM, Kobayashi Y, Kamimoto H, et al. Aberrantly activated Wnt/β-catenin pathway co-receptors LRP5 and LRP6 regulate osteoblast differentiation in the developing coronal sutures of an Apert syndrome (Fgfr2S252W/+) mouse model. Dev Dyn, 2021, 250(3): 465-476.
34. Hopper RA, Wang HD, Mercan E. Le Fort Ⅱ distraction with simultaneous zygomatic repositioning. Clin Plast Surg, 2021, 48(3): 487-496.
35. Liu MT, Kurnik NM, Mercan E, et al. Magnitude of horizontal advancement is associated with apnea hypopnea index improvement and counter-clockwise maxillary rotation after subcranial distraction for syndromic synostosis. J Oral Maxillofac Surg, 2021, 79(5): 1133.e1-1133.e16.
36. Hopper RA, Kapadia H, Susarla SM. Le Fort Ⅱ distraction with zygomatic repositioning: a technique for differential correction of midface hypoplasia. J Oral Maxillofac Surg, 2018, 76(9): 2002.e1-2002.e14.
37. McGrath J, Gerety PA, Derderian CA, et al. Differential closure of the spheno-occipital synchondrosis in syndromic craniosynostosis. Plast Reconstr Surg, 2012, 130(5): 681e-689e.
38. Burdi AR, Kusnetz AB, Venes JL, et al. The natural history and pathogenesis of the cranial coronal ring articulations: implications in understanding the pathogenesis of the Crouzon craniostenotic defects. Cleft Palate J, 1986, 23(1): 28-39.
39. Meazzini MC, Corradi F, Mazzoleni F, et al. Circummaxillary sutures in patients with Apert, Crouzon, and Pfeiffer syndromes compared to nonsyndromic children: growth, orthodontic, and surgical implications. Cleft Palate Craniofac J, 2021, 58(3): 299-305.
40. Forte AJ, Alonso N, Persing JA, et al. Analysis of midface retrusion in Crouzon and Apert syndromes. Plast Reconstr Surg, 2014, 134(2): 285-293.
41. Resnick CM, Kim S, Yorlets RR, et al. Evaluation of Andrews’ analysis as a predictor of ideal sagittal maxillary positioning in orthognathic surgery. J Oral Maxillofac Surg, 2018, 76(10): 2169-2176.
42. Susarla SM, Ettinger RE, Egbert MA. Transmucosal pterygomaxillary separation in the Le Fort Ⅰ osteotomy. Plast Reconstr Surg, 2020, 145(5): 1262-1265.
43. Hopper RA, Sandercoe G, Woo A, et al. Computed tomographic analysis of temporal maxillary stability and pterygomaxillary generate formation following pediatric Le Fort Ⅲ distraction advancement. Plast Reconstr Surg, 2010, 126(5): 1665-1674.
44. Susarla SM, Ettinger R, Preston K, et al. Technical modifications specific to the cleft Le Fort Ⅰ osteotomy. J Craniofac Surg, 2020, 31(5): 1459-1463.
45. Reitsma JH, Ongkosuwito EM, Buschang PH, et al. Facial growth in patients with apert and crouzon syndromes compared to normal children. Cleft Palate Craniofac J, 2012, 49(2): 185-193.
46. Zhou X, Pu D, Liu R, et al. The Fgfr2(S252W/+) mutation in mice retards mandible formation and reduces bone mass as in human Apert syndrome. Am J Med Genet A, 2013, 161A(5): 983-992.
47. Kreiborg S. Crouzon Syndrome. A clinical and roentgencephalometric study. Scand J Plast Reconstr Surg Suppl, 1981, 18: 1-198.
48. Wink JD, Bastidas N, Bartlett SP. Analysis of the long-term growth of the mandible in Apert syndrome. J Craniofac Surg, 2013, 24(4): 1408-1410.
49. Costaras-Volarich M, Pruzansky S. Is the mandible intrinsically different in Apert and Crouzon syndromes? Am J Orthod, 1984, 85(6): 475-487.
50. Reitsma JH, Elmi P, Ongkosuwito EM, et al. A longitudinal study of dental arch morphology in children with the syndrome of Crouzon or Apert. Eur J Oral Sci, 2013, 121(4): 319-327.
51. Agochukwu NB, Solomon BD, Doherty ES, et al. Palatal and oral manifestations of Muenke syndrome (FGFR3-related craniosynostosis). J Craniofac Surg, 2012, 23(3): 664-668.
52. Posnick JC, Choi E, Liu S. Occurrence of a “bad” split and success of initial mandibular healing: a review of 524 sagittal ramus osteotomies in 262 patients. Int J Oral Maxillofac Surg, 2016, 45(10): 1187-1194.
53. Susarla SM, Cho DY, Ettinger RE, et al. The low medial horizontal osteotomy in patients with atypical ramus morphology undergoing sagittal split osteotomy. J Oral Maxillofac Surg, 2020, 78(10): 1813-1819.
54. Wenger TL, Hopper RA, Rosen A, et al. A genotype-specific surgical approach for patients with Pfeiffer syndrome due to W290C pathogenic variant in FGFR2 is associated with improved developmental outcomes and reduced mortality. Genet Med, 2019, 21(2): 471-476.
55. Doerga PN, Spruijt B, Mathijssen IM, et al. Upper airway endoscopy to optimize obstructive sleep apnea treatment in Apert and Crouzon syndromes. J Craniomaxillofac Surg, 2016, 44(2): 191-196.
56. Al-Namnam NMN, Hariri F, Rahman ZAA. Distraction osteogenesis in the surgical management of syndromic craniosynostosis: a comprehensive review of published papers. Br J Oral Maxillofac Surg, 2018, 56(5): 353-366.
57. Kim BJ, Bae HS, Lee Y. One-stage treatment for adult patients with crouzonoid appearance by orthognathic and face contouring surgery. J Craniofac Surg, 2017, 28(5): e441-e444.
58. Vyas K, Gibreel W, Mardini S. Virtual surgical planning (VSP) in craniomaxillofacial reconstruction. Facial Plast Surg Clin North Am, 2022, 30(2): 239-253.
59. Dumas BM, Nava A, Law HZ, et al. Three-dimensional printing for craniofacial surgery: a single institution’s 5-year experience. Cleft Palate Craniofac J, 2019, 56(6): 729-734.

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