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Skull Base Cephalometric Changes in Cranial Expansion by Springs

de Faria Valle Dornelles, Rodrigo MD, MSc*; Cardim, Vera Lúcia Nocchi MD, PhD; de Campos Fonseca Pinto, Ana Carolina Brandão MD, PhD; Alonso, Nivaldo MD, PhD§

Journal of Craniofacial Surgery: July 2011 - Volume 22 - Issue 4 - p 1496-1501
doi: 10.1097/SCS.0b013e31821d4c50
Scientific Foundation
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Background: The use of springs in cranial expansion has demonstrated to be effective for craniosynostosis treatment. The spring-exerted expansile action has been observed when springs are placed both in the sagittal and parasagittal regions, mainly in scaphocephaly. In this study, a variation in cephalometric measurements under expansible spring action on the skull base was analyzed.

Methods: Thirteen 4-week-old New Zealand white rabbits were divided into 4 groups: group 1, in which only amalgam markers were used (control); group 2, in which amalgam markers were used, and a sagittal suturectomy was performed; group 3, in which amalgam markers were used, and a sagittal suturectomy was performed with placement of expansible springs in the interparietal region; and group 4, in which markers were used, and a linear parasagittal craniectomy was performed with spring placement. All animals were killed at weeks 2, 4, 8, and 12. Radiologic control with cephalometric study was performed.

Results: Distraction of amalgam markers in the groups with springs was greater than in those without springs. A proportional change in the angles measured through craniometry was observed in these groups.

Conclusions: The experimental rabbit model was shown to be adequate to the analysis proposed by the study. Under the action of springs, the groups with sagittal and parasagittal osteotomy were found to present a similar distraction of amalgam markers. A concomitant change in cephalometric measurements occurred, suggesting a change in the skull base mediated by expansible springs placed both in the sutural and nonsutural sites.

From *Plastic Surgery, São Paulo University Medical School; †General Surgery, Hospital Beneficencia Portuguesa; ‡Surgery Division, São Paulo University Veterinary School; and §Plastic Surgery Division, São Paulo University Medical School, São Paulo, Brazil.

Received August 16, 2010.

Accepted for publication November 13, 2010.

Address correspondence and reprint requests to Rodrigo de Faria Valle Dornelles, MD, MSc, Núcleo de Plástica Avançada, Rua Martiniano de Carvalho 907, 01321-001, São Paulo/SP, Brazil; E-mail: rodrigo@npa.med.br

The authors report no conflicts of interest.

© 2011 Mutaz B. Habal, MD