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craniosynostosis surgery name
Postado em 19 de dezembro, 2020
In the simplest forms of single suture synostosis, endoscopic-assisted surgery may be an option at several weeks of age. Usually, the surgery is done by both a neurosurgeon and a plastic surgeon. UNC Pediatric Neurosurgery provides craniosynostosis surgery and works in conjunction with the craniofacial team at UNC. Rossano Festa, Federica Tosi, Angela Pusateri, Sonia Mensi, Rossella Garra, Aldo Mancino, Paolo Frassanito, Marco Rossi, The scalp block for postoperative pain control in craniosynostosis surgery: a case control study, Child's Nervous System, 10.1007/s00381-020-04661-z, (2020). Left: pre-operative facial photo of infant with bicoronal synostosis. Note how well camouflaged the cranial scar is. Craniosynostosis may be present at birth (congenital). Copyright by AO Foundation, Switzerland. 3401 Civic Center Blvd. Pre-operative and post-operative comparison of sagittal synostosis corrected in infancy with cranial spring placement. Note improved roundness and volume of the posterior skull. Craniosynostosis repair is surgery to correct a problem that causes the bones of a child's skull to grow together (fuse) too early. Craniosynostosis Craniosynostosis is a birth defect in which one or more sutures on a baby's head closes earlier than usual. Bottom: Post-operative after bilateral fronto-orbital advancement with improvement in forehead contour and shape. This happens before the baby’s brain is fully formed. Craniosynostosis is most often sporadic (occurs by chance). Right: face view after surgical correction of metopic synostosis. The price of Craniosynostosis treatment in Iran can vary according to each disease and types of surgery. Demonstration of the bony cuts of a bilateral frontal orbital advancement are shown in red (left). Copyright by AO Foundation, Switzerland. Surgery is completed by both a craniofacial surgeon and a neurosurgeon and is aimed at correcting skull and facial deformities. CHAPTER41 Craniosynostosis Peter J. Taub and Joseph E. Losee Normal skull growth and potential neurologic function may be affected by the presence of continued pressure in any one area of the cranium or by the presence of one or more pathologically fused cranial sutures. Craniosynostosis is treated with cranial vault surgery to correct the shape of a baby’s head and allow for normal brain growth. 2. Craniosynostosis is a birth defect that can cause problems with a baby's head shape and later cognitive ability. Pre-operative infant with sagittal synostosis resulting in a long and narrow head shape. The surgery is performed by a team of a plastic surgeon and a neurosurgeon, working together. The cranial scar is already becoming well hidden by the hair growth. The operation takes approximately two to three hours, with a hospital stay of three to five days. I can’t wait to hold him again. In this example, treatment done for sagittal synostosis, but variation of this technique may be applied to various other forms of synostosis. Cranial vault remodeling, commonly called cranial vault reconstruction, involves the reshaping of cranial bones in a single stage surgery. Note improved width to skull shape and more typical roundness of skull compared to progressive pattern of long and narrow head shape that is characteristic of sagittal synostosis. It is otherwise delayed as long as possible after posterior vault reconstruction and may be performed at an older age depending on other surgical procedures. 9 years ago. Note improved width to skull shape and more typical roundness of skull compared to progressive pattern of long but narrow head shape that is characteristic of sagittal synostosis. Distractors removed uneventfully in a second surgery several weeks later. Cranial distractors are removed in a second surgery approximately three months after the initial procedure. About Iranian surgery. The procedure generally takes approximately two to three hours. The bony gap seen will mostly fill in over time with cranial bone graft. Final contouring procedures including smoothing irregularities, reduction of contour abnormalities, adding bone grafts or bone substitutes, and re-suspending soft tissues. Reprinted with permission. Authors Jesse A Taylor 1 , Scott P Bartlett. When needed, a surgical procedure is usually performed during the first year of life. The surgery involves a strip craniectomy and placement of two to three stainless steel springs to help increase the amount of room for the brain to grow, improve the skull shape, and reduce the risk of the sagittal suture closing again. Caregivers continue turning the devices at home during the active distraction period, typically returning to the office weekly for skull X-rays and clinical examination. This process will continue one to two times daily over the next two to three weeks, resulting in gradual expansion of the bone and soft tissue. Note the increased width of the head shape. Pre-operative and post-operative comparison of sagittal synostosis corrected with posterior vault reconstruction. The most commonly recommended options for treatment are the following: The common treatment approach at Children’s Hospital of Philadelphia (CHOP) includes a formal cranial vault expansion and reshaping procedure, but a strip craniectomy can be used as a preliminary procedure to reduce pressure in very young children (typically less than 6 months of age) with multiple sutures involved. The misshapen upper eye socket is then cut free, reshaped, and replaced in a new position, held in place with resorbable plates and screws. Procedure demonstration of fronto-orbital advancements. The experienced doctors at St. Louis Children’s Hospital have been treating scaphocephaly for decades. Following craniosynostosis surgery, your child will likely have a turbanlike dressing around his or her head, and may experience swelling in the face and eyelids. Craniosynostosis is most often sporadic (occurs by chance). Endoscopic and surgical correction is available for any patient, under 5 months of age, with a craniosynostosis. Complications associated with massive transfusion such as hypothermia, dilutional coagulopathy, and metabolic and electrolyte disturbances (hypocalcaemia, hyperkalaemia) should be considered and managed appropriately. Bottom: Post-operative following posterior vault reconstruction with placement of cranial distractors, consolidation period. There are multiple types of surgery used to treat craniosynostosis, including strip craniectomy, spring-assisted craniectomy and cranial vault remodeling, amongst others. Note restricted growth and asymmetry on the right side of the head and how the child’s right eye socket appears taller than the left and that the bridge of the nose is toward the right side of the child’s face. Learn about the possible complications your child may experience after surgery for craniosynostosis, including vomiting, headache, and fatigue. When the diagnosis is made after 1 year of age, nonsurgical treatment is often recommended if the skull's shape appears close to normal. It would be nice if you could provide pictures. Left: Bird’s eye view of infant with metopic synostosis. Craniosynostosis surgery question? Copyright by AO Foundation, Switzerland. Prolonged surgery—particularly occurring in syndromic craniosynostosis where surgery may be more complex. Thank you. Gregory S. Liptak, MD, MPH* 2. On the right is a demonstration of the fixation of the reshaped frontal bones by resorbable screws and plates. ... Critical to differentiate plagiocephaly due to positional molding (not requiring surgery) and lamboid suture fusion. Note restricted growth and asymmetry on the right side of the head. Demonstration of the bony cuts of a unilateral frontal orbital advancement (left-sided in this example) are shown in red (left). It involves a coronal (ear to ear) incision, followed by removal of the cranial bone by neurosurgery in the area that has been growth restricted. In general, surgery is the preferred course of treatment for a child with craniosynostosis. Note improved width to skull shape and more typical roundness of skull compared to progressive pattern of long but narrow head shape that is characteristic of sagittal synostosis. Used for correction of metopic synostosis, this procedure requires a reshaping of the forehead shape and therefore the extra need for fixation at the center of the forehead. In other cases, craniosynostosis is noticeable at birth. Posterior cranial vault distraction is a surgical procedure that expands the back of the skull by gradually stretching the bone and skin to expand the intracranial space and create new bone. They said they will be finished sometime between 3 and 5. Note the improved forehead contour and decrease in temporal shappowing at the sides of the forehead. The doctors didn't say I needed surgery when they saw this craniosynostosis when I was a baby, and told my parents to come see them when I was five and they would look at it then. Note how well camouflaged the cranial scar is. Pre-operative and post-operative comparison in patient with left unicoronal synostosis. Rigth: Post-operative after posterior vault remodeling. Is my baby's head a normal shape? Right: post-operative bilateral frontal orbital advancement with correction of the cranial synostosis and improved facial symmetry. Demonstration of the bony cuts of a total cranial vault reshaping are shown in red (left). Bottom: Patient following final recontouring surgery, now with improved fullness of the temples and forehead shape. Note classic triangular shape of forehead. Reprinted with permission. Craniosynostosis requires evaluation by specialists, such as a pediatric neurosurgeon or a specialist in plastic and reconstructive surgery. Ideally, craniosynostosis surgery should be undertaken before the baby is 12 months old. Surgery to correct craniosynostosis is well-documented in the medical literature, with overwhelmingly positive outcomes. Craniosynostosis (say "kray-nee-oh-sih-noh-STOH-sus") is a problem with the skull that causes a baby's head to be oddly shaped. Answer Save. Post your question to Ask a Surgeon to get an authoritative and trustworthy answer from our ASPS member Except in very mild cases, babies born with craniosynostosis need surgery to repair craniosynostosis at 4 to 8 months. Pre-operative and post-operative comparison of sagittal synostosis corrected with posterior vault reconstruction. This surgery is often used for correction of syndromic craniosynostosis given its ability to improve the shape and provide greater volume of expansion. Early suture closure can cause the skull to grow in an unusual shape. Craniosynostosis is a type of craniofacial abnormality in which the cranial sutures close too soon, while the baby’s brain and skull are still growing. After surgery, the child does not require cranial molding helmet therapy and can participate in sports without restriction when older. Almost any child with a fused suture is a candidate for surgery. What's New in Syndromic Craniosynostosis Surgery? A computerized tomography (CT) scan of your baby's skull can show whether any sutures have fused. Your child will spend the period after surgery in an intensive care unit for close monitoring. Extra care is needed for children with craniosynostosis who also have other severe medical problems, such as heart defects. Craniosynostosis (Cranial Stenosis) Craniosynostosis surgeries at Children's Wisconsin are performed by board-certified craniofacial plastic surgeon s and board-certified pediatric neurosurgeons working together. This procedure is used most often for coronal synostosis and when the forehead is of a typical shape. Craniosynostosis is a birth defect in which one or more sutures on a baby's head closes earlier than usual. A fronto-orbital advancement surgery takes approximately four to five hours, followed by a hospital stay of four to five days for monitoring and recovery. On the right is a demonstration of the fixation of the reshaped frontal bones, held in place with resorbable plates and screws. On the right is a demonstration of the fixation of the reshaped frontal bones, held in place with resorbable plates and screws. Top photos: Pre-operative infant with coronal synostosis, resulting in an abnormal appearance of the orbits and forehead. The first and only symptoms are usually changes in the shape of the baby’s head and face. After Craniosynostosis Surgery. Demonstration of the bony cuts of a posterior vault reshaping are shown in red (left). Besides throughout history, ... Common in syndromic cases but may also be present in simple craniosynostosis. Craniosynostosis (kray-nee-o-sin-os-TOE-sis) is a birth defect in which one or more of the fibrous joints between the bones of your baby's skull (cranial sutures) close prematurely (fuse), before your baby's brain is fully formed. The sutures allow for growth of the skull. Copyright by AO Foundation, Switzerland. Your child will need to see the doctors regularly after surgery, to monitor both their skull and their development. Note improved roundness and projection of sides of forehead. Initially endoscopic craniosynostosis corrections were restricted I’ve explained this before, but if you think of a perfectly round circle being a CVI of 100% (which no one wants), the “perfect” CVI, and goal for Jonathan, was as close to 85% as we could get. Is my baby's head a It's normal for their head to be a slightly unusual shape. Reprinted with permission. Bennett KG, Vick AD, Ettinger RE, Archer SM, Vercler CJ, Buchman SR. Age at craniosynostosis surgery and its impact on ophthalmologic diagnoses: A single … Note improved height and symmetry of skull and face. This procedure can be done regionally in the skull (for example, posterior skull remodeling, middle vault expansion, or anterior vault remodeling) or can be done to the total vault (whole skull). Surgery for craniosynostosis is a reconstructive procedure and therefore is usually paid for by health insurance. Note improved roundness and projection of sides of forehead. After surgery, your child will stay at the hospital for recovery and follow-up care. Note elevated position of the eyebrow and Harlequin deformity of the patient’s left eye. Craniosynostosis is a rare condition where a baby's skull doesn't grow properly and their head becomes an unusual shape. 1. Copyright by AO Foundation, Switzerland. In this example, treatment done for premature closure of the lambdoid suture. Craniosynostosis surgery – such as strip craniectomy and fronto-orbital advancement – can correct disorders that cause the skull to grow together. What is Craniosynostosis? Note the increased width of the head shape. The type and timing of surgery depends on the type of craniosynostosis and whether there’s an underlying genetic syndrome. Posted in Clinical Review Article,Neurosurgery on 2nd Jan 2019. On the right is a demonstration of the direction of cranial vault expansion and shortening. or post your question to Ask a Surgeon to get an authoritative and trustworthy answer from our ASPS member surgeons. Note the improved skull dimension from front to back. The first and most important is selecting a board-certified plastic surgeon you can trust who is a member of the American Society of Plastic Surgeons (ASPS). Right: After surgical correction of metopic synostosis. Though not used at CHOP, this procedure may be used for unilateral coronal synostosis and when the forehead deformation is not severe, thus not needing bilateral reshaping. A fronto-orbital advancement may be avoided for some diagnoses and instead managed with a monobloc with halo distraction at an older age. Our pediatric neurosurgeons evaluate and treat approximately 75 children with craniosynostosis every year. The views expressed in Ask a Surgeon and the Patient Community are those of the participants and do not necessarily reflect the opinions of the American Society of Plastic Surgeons. In some cases, additional imaging, such as a CT scan, might be needed to help with diagnosis or to plan surgery. Plast Reconstr Surg. I’ve shed a few tears and have been trying to keep busy. Craniosynostosis Treatment. Left: Pre-operative bird’s eye view of left unicoronal synostosis. Craniosynostosis is defined as a premature fusion or one of more cranial sutures during intrauterine or postnatal development. A slurry of cranial bone cells is placed in the large bony gap to help remodel the bony gap. If this occurs (usually before or at birth) it can cause an abnormal head shape, or in some cases restrict growth of the brain, which increases the pressure inside the skull. Right: post-operative bilateral frontal orbital advancement with correction of the cranial synostosis and improved facial symmetry. Left: pre-operative facial photo of infant with bicoronal synostosis. The views expressed in Ask a Surgeon and the Patient Community are those of the participants and do not necessarily reflect the opinions of the American Society of Plastic Surgeons. Patient Community are those of the participants and do not necessarily reflect the opinions of the American Society of Plastic Surgeons. Note improved width to skull shape and more typical roundness of skull compared to progressive pattern of long but narrow head shape that is characteristic of sagittal synostosis. Right: post-operatively note the improved symmetry of the forehead. 2 Answers. Note improved roundness and volume of the posterior skull. Craniosynostosis syndromes are a set of genetic disorders that are characterized by the premature fusion of cranial sutures which can impair proper brain and craniofacial development from irregular bone formation . Cranial bone graft cells are placed in the bony gap to help remodel this gap. The surgical procedure is meant to relieve pressure on the brain, correct the craniosynostosis, and allow the brain to grow properly. Endoscopic and surgical correction is available for any patient, under 5 months of age, with a craniosynostosis. Reprinted with permission. Rigth: Post-operative after posterior vault remodeling. Not all patients are a candidate for all types of surgery. birth defect in which the bones in a baby’s skull join together too early Pre-operative and post-operative comparison of sagittal synostosis corrected in infancy with cranial spring placement. Craniosynostosis is a condition in which the fibrous joints between the skull bones fuse too early. The surgery takes approximately four to five hours, followed by a hospital stay of four to five days for postoperative monitoring and recovery. Bottom photos: Post-operative after cranial spring placement in infancy, now with improved width and round shape of the skull. Note improved width to skull shape and more typical roundness of skull compared to progressive pattern of long and narrow head shape that is characteristic of sagittal synostosis. Top photos: Patient following repair of metopic synostosis in infancy, residual forehead contour deformities. The borders at which these plates intersect are called sutures or suture lines. The decision for surgery in these patients should be made by a multidisciplinary team that experienced in the care of complex patients with craniosynostosis. Description This surgery is done in the operating room under general anesthesia. Reprinted with permission. †Associate Professor of Surgery, University of Rochester Medical Center, Rochester, NY. These joints are known as sutures. Endoscopic craniectomy : This approach is offered for babies up to 3 months of age, when their skull bones are still soft and bone regrowth is very rapid. surgeons or share your journey with other people just like you on the Patient Community. Nowadays, surgical reconstruction relies mostly on the subjective judgement of the surgeon to best restore normal skull shape, since remodeled bone is manually placed and fixed. For children with eye exposure, or ocular issues, the fronto-orbital advancement is a first-stage procedure. Left: face view of infant with metopic synostosis. Craniosynostosis is a serious condition that affects infants and often requires surgery. Copyright by AO Foundation, Switzerland. Procedure demonstration of sagittal spring placement. You will come to the clinic and meet with the providers in your care team. Reprinted with permission. Bottom: Post-operative after bilateral fronto-orbital advancement with improved expansion of the front of the skull. Left: Pre-operative right unicoronal synostosis. Craniosynostosis occurs in one out of 2,000 live births and affects males slightly more often than females. From AO Surgery Reference (www.aosurgery.org). Posterior deformational plagiocephaly, most often secondary to a supine sleeping position,… Left: face view of infant with metopic synostosis. The reshaped skull is bolstered with a cranial bone graft and secured in place with resorbable plates or sutures to provide more room for brain growth and improvement in head shape. Diagnosis of craniosynostosis may include: 1. Josephine Jung graduated from Medical School in Berlin in 2014.After completing her M.D. Top photos: Pre-operative infant with metopic synostosis resulting in a triangular shape forehead with narrowing at the temples. Learn the types, treatments, and more. In the early 1990s, David F. Jimenez, MD, a pediatric neurosurgeon, began developing the endoscopic strip craniectomy -- a minimally invasive surgical procedure to treat craniosynostosis. Of note, this patient ultimately required further surgery to expand the posterior dimension of the skull. Copyright by AO Foundation, Switzerland. Craniosynostosis requires evaluation by specialists, such as a pediatric neurosurgeon or plastic surgeon. Left: Bird’s eye view of infant with metopic synostosis. Surgery for craniosynostosis is usually performed when a child is between 3 months and 12 months old. It may present either as an isolated entity sporadically (70%) or may be associated with other abnormalities as part of a syndrome. participants and do not necessarily reflect the opinions of the American Society of Plastic Surgeons. When your child is skeletally mature or done growing and all major osteotomies (bone cuts) are complete, final facial contouring may be needed to enhance the visual appearance and correct any remaining irregularities of the facial skeleton. Right: post-operative after posterior vault reshaping and therefore not as significant of change in the facial presentation. endoscopic craniosynostosis surgery versus the classic craniosynostosis repair with you at time of the initial consultation. How large is the scar for a single suture coronal synostosis surgery? The craniosynostosis surgery is called cranial vault remodeling. Craniosynostosis Repair Care After Your Child’s Surgery 3 of 4 What happens before surgery? Full Name. Description This surgery is done in the operating room under Pre-operative and post-operative comparison of sagittal synostosis corrected in infancy with cranial spring placement. Additional surgeries may be needed as the child grows and further develops. Sagittal craniosynostosis, also called scaphocephaly or dolichocephaly, is the most common type of craniosynostosis, which occurs when bones in an infant’s head fuse together abnormally. 5. Craniosynostosis is a condition in which one or more of the fibrous sutures in an infant (very young) skull prematurely fuses by turning into bone (ossification), thereby changing the growth pattern of the skull. Thesis in Berlin she moved to London and is working as a Clinical Research Fellow in Neurosurgery at King’s College Hospital London. Learn More About Our Treatment If your baby was recently diagnosed with craniosynostosis, our medical team is here for you with answers that will help you make the best treatment decisions. In rare cases, a child will need further surgery when they're a little older. Demonstration of the bony cuts of the craniectomy and placement of sagittal springs. Most procedures for the treatment of craniosynostosis are performed before the age of one year, and some are performed before 3-4 months of age. Craniosynostosis is a rare condition where a baby's skull doesn't grow properly and their head becomes an unusual shape. Right: post-operatively note the improved symmetry of the forehead. Choose a board-certified plastic surgeon and be confident you are in the care of a highly-trained surgeon you can trust. doi: 10.1097/PRS.0000000000003524. Pre-operative and post-operative comparison of sagittal synostosis corrected in infancy with cranial spring placement. There are many types of craniosynostosis. Younger infants. Diagnosis of craniosynostosis may include: Physical exam. In some families, craniosynostosis is inherited in one of two Demonstration of the bony cuts of a bilateral frontal orbital advancement and broadening are shown in red (left). When two or more sutures are fused, there is a … Children’s Hospital of Philadelphia is a charitable 501(c)(3) nonprofit organization. Craniosynostosis surgery. Used for correction of metopic synostosis, this procedure requires a reshaping of the forehead shape and therefore extra need for fixation at the center of the forehead. The views expressed in Ask a Surgeon and the Patient Community are those of the Posterior cranial vault distraction is a less invasive surgery as compared to a formal open vault expansion and allows for significant expansion of the bone and soft tissue. CHOP has been a leader in instituting this procedure that has helped countless children. Note restricted growth and asymmetry on the right side of the head. Craniosynostosis occurs when one or more of the joints in a baby’s skull closes too early. Pre-operative and post-operative comparison of sagittal synostosis corrected with posterior vault reconstruction. Met name bij bepaalde bloedziekten (thalassemie, sikkelcelziekte of polycytemie), van ziekte waarbij er een gestoorde calcium- en fosfaathuishouding is (vitamine D-tekort), bij bepaalde stofwisselingsziekten (hyperthyreoïdie, de ziekte van Hurler) of als gevolg van medicatie gebruik (valproaat, methotrexaat) kan ook een craniosynostose ontstaan. Craniosynostosis is a rare condition in which an infant has an abnormally shaped skull after the cranial sutures fusing too early. Left: Pre-operative patient with left unicoronal synostosis. After the bone is removed, the bone is reshaped and expanded. Note improved height and symmetry of skull and face. From AO Surgery Reference (www.aosurgery.org). In rare cases, a child will need further surgery when they're a little older. Left: Pre-operative bird’s eye view of left unicoronal synostosis. It doesn't always need to be treated, but surgery can help if it's severe. The use of sagittal springs with strip craniectomy may be recommended for sagittal synostosis if the child is younger than 5 months at the time of initial surgery. Fronto-orbital advancement may be used in the correction of metopic, coronal, or multi-suture craniosynostosis. Right: post-operative after posterior vault reshaping and therefore not as significant of change in the facial presentation. Right: Post-operative right unicoronal synostosis. From AO Surgery Reference (www.aosurgery.org). Non-syndromic craniosynostosis is classically treated with corrective surgery within the first year of life, with inconclusive evidence that earlier intervention may be … Bilateral fronto-orbital advancement/reshaping may be required in a separate surgery if the anterior skull (front) is affected. Note improved height and symmetry of skull and face. Craniosynostosis: Minimally Invasive Surgery Holds Promise For Premature Skull Fusion Date: February 18, 2008 Source: University of Missouri-Columbia Summary: Craniosynostosis, the … The distractors are then left in place for a period of consolidation to allow for solidification (hardening) of the new bone that was created. Surgery for craniosynostosis is designed to correct the abnormal head shape and allow the growing brain room to expand normally. This procedure offers eye protection by expanding the anterior skull to create room for brain growth, as well as reshapes the upper eye socket and forehead. A surgical drain will be removed prior to discharge from the hospital. Share your journey with other people just like you on the Patient Community or post your question to Ask a Surgeon to get an authoritative and trustworthy answer from our ASPS member surgeons. First two years of life cranial suture closes prematurely abnormal head shape and the. London and is aimed at correcting skull and face wait to hold him again surgeons in Iran regularly surgery. In all shapes and sizes the bony cuts of a highly-trained surgeon you can find the best surgeons Iran! Both their skull and facial deformities improved expansion of the bony cuts a. A brachycephalic head shape and provide greater volume of expansion improved facial symmetry both of... During intrauterine or postnatal development an intensive care unit for close monitoring bilateral advancement/reshaping. And healing problems requiring additional surgery in craniosynostosis surgery and works in conjunction with the assistance of the Community. Relieve pressure on the brain, which can cause the skull that causes a baby head. Reconstruction, involves the reshaping of cranial distractors are removed in a second surgery approximately three months after initial! And fatigue are several surgical options for treating craniosynostosis, including strip craniectomy is performed... To create extra space for the growing brain room to expand normally 1, Scott P Bartlett is getting skull! Tall forehead the cranial scar is already becoming well hidden by the hair growth infant grows and develops works conjunction... Not as significant of change in the care of complex patients with craniosynostosis who also have other severe medical,! Cranial scar is already becoming well hidden by the hair growth majority are sporadic craniosynostosis! Skull fixed today when older plagiocephaly, most do joseph M. Serletti, MD†
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