Konjenital Nonsendromik Dentofasiyal Deformitelerde Distraksiyon Osteogenezi

Öz

Konjenital fasiyal deformiteler gerek mevcut deformite, gerekse deformitenin gelişim sürecindeki yansıması olarak görülebilmektedir. Gelişimsel sorunlar sıklıkla mandibula veya orta yüz bölgesinde maksilla gelişiminde beliren yetersizlik ve buna bağlı olarak çevre dokularda oluşan orantı problemleri ile kendisini göstermektedir. Gelişim geriliğinin en önemli nedenleri arasında yapılan onarım sonrası ortaya çıkan skarın kemik gelişimini engellemesi , kemiğin gelişim odağının deforme olması ve çevre yumuşak doku eksiklikleri sayılabilmektedir. Kemik augmentasyonunu gerektiren fasiyal konjenital deformiteler arasında; Pierre-Robin sekansı, dudak damak yarıklarına sekonder orta yüz gerilikleri, kraniofasiyal mikrozomi sayılabilir. Sözü edilen deformite spektrumu, klasik ortognatik cerrahi veya distraksiyon osteogenezi ile kemik yapının restorasyonu ve bunlara ek olarak yumuşak doku augmentasyonları ile rekonstrükte edilebilmektedir. Kemik doku restorasyonunda ilerletme olanaklarının daha fazla olması,yeni kemik elde edilebilmesi, serbest doku nakli gereksinimini azaltması ve daha stabil bir onarım imkanı sağlaması nedenleri ile distraksiyon osteogenezi son yılarda daha etkin bir tedavi yöntemi olarak görülmektedir

Anahtar Kelimeler

• Fasiyal deformite, Dudak damak yarığı, Distraksiyon osteogenezi, Fasiyal gelişim, Pierre-Robin sekansı, Ortognatik cerrahi, Kraniofasyal mikrozomi

Konjenital Nonsendromik Dentofasiyal Deformitelerde Distraksiyon Osteogenezi Distraction Osteogenesis in Congenital Nonsyndromic Dentofacial Deformities

Abstract

Congenital deformities in the face occur due to accompanying congenital facial deformity or developmental problems secondary to deformities. Scar formation after surgery or soft tissue deficiencies around the deformity may enhance the developmental problems. The most common congenital facial deformities requiring skeletal correction are deformities secondary to cleft lip and palate, Pierre-Robin Sequence, and craniofacial microsomia. All these deformities can be treated with bony advancement with classical orthognathic surgery or distraction osteogenesis and soft tissue augmentation procedures. The treatment planning for these deformities is complex and difficult, because the required amount of bony advancement is generally quite large and there is inadequate soft tissue coverage of the area. Orthognathic surgery is more difficult to perform in cleft lip and palate cases and impossible for the micrognathic newborn. Due to longer and more stable advancement opportunities, distraction osteogenesis has become more popular in bony restoration of congenital facial deformities

Keywords

• Facial deformity, Pierre-Robin Sequence, Craniofacial microsomia, Cleft lip-palate, Distraction osteogenesis, Maxillofacial development, Orthognathic surgery

Kaynakça

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