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Plast Reconstr Surg. 2017 Dec;140(6):794e-803e. doi: 10.1097/PRS.0000000000003879.

Five-Year Follow-Up of Midface Distraction in Growing Children with Syndromic Craniosynostosis.

Author information

1
New York, N.Y. From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center.

Abstract

BACKGROUND:

Maxillary position in patients with syndromic craniosynostosis after midface distraction has been shown to be stable 1 year postoperatively. The purpose of this study is to assess midfacial position in the growing child with craniosynostosis 5 years after Le Fort III advancement with a rigid external device.

METHODS:

Seventeen consecutive patients were identified to have the diagnosis of syndromic craniosynostosis and had undergone midface advancement [corrected]. There were 10 boys and seven girls, seven patients had Crouzon syndrome, five had Apert syndrome, and five had Pfeiffer syndrome. A standard subcranial Le Fort III osteotomy was performed. Cephalometric analysis was performed to assess the position of the maxilla.

RESULTS:

After device removal, orbitale advanced 13.67 mm along the x axis and downward 1.70 mm along the y axis. The A point advanced 15.97 mm along the x axis and downward 1.14 mm along the y axis. At 1 year after distraction, both orbitale and A point had advanced an additional 0.47 mm and 0.24 mm along the x axis and downward 0.58 mm and 1.78 mm along the y axis, respectively. At 5 years after distraction, the orbitale moved posterior 0.58 mm and the A point advanced an additional 2.08 mm along the x axis. Orbitale and A point descended 3.23 mm and 5.2 mm along the y axis, respectively.

CONCLUSION:

After Le Fort III advancement with distraction, the maxillary position remains stable and continues to advance minimally along the x axis and demonstrates more growth along the y axis over the long term.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.

PMID:
28820838
DOI:
10.1097/PRS.0000000000003879
[Indexed for MEDLINE]

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