Fronto-orbital Advancement by Piezosurgery: Introduction of a New Osteotomy Technique

Introduction: The advancement of the fronto-orbital complex is a standard procedure to increase the intracranial volume and to improve the facial appearance in patients with craniosynostosis. Relevant complications include severe hemorrhage and trauma of intracranial, orbital, or facial soft tissues, which mostly arise during the osteotomy process performed with burrs or saws. To minimize the risk of soft tissue injury and to increase the precision of the osteotomy, we used a piezoelectric osteotome for fronto-orbital advancement. The aim of this study is to report our experiences with piezoelectric osteotomies in 15 children with craniosynostosis.

Material and Methods: Fifteen consecutive pediatric patients with craniosynostosis (average age: 1.6 years) underwent craniofacial surgery including fronto-orbital advancement between January and November 2004. Osteotomies for fronto-orbital advancement were exclusively performed with a piezoelectric osteotome. Intra- and postoperative experiences were collected.

Results: In all patients this instrument allowed an easy and precise osteotomy without occurrence of any complications. Due to less extensive preparation needs for osteotomy, the piezoelectric osteotomy was less traumatic and saved operation time. Postoperatively, osseous regeneration was uneventful.

Conclusions: We conclude that this new technique of piezoelectric osteotomy is a valuable technical innovation for fronto-orbital advancement in pediatric patients.