Long-term follow-up of large maxillary advancements with distraction osteogenesis in growing and non-growing cleft lip and palate patients. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Meazzini, Maria Costanza; Basile, Valentina; Mazzoleni, Fabio; Bozzetti, Alberto; Brusati, Roberto
• Is Part Of: Journal of plastic, reconstructive & aesthetic surgery. Volume 68:Issue 1(2015:Jan.)
• Page Start: 79
• Page End: 86
• Publication Date: 2015-01
• Subjects: Surgery, Plastic -- Great Britain -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Great Britain -- Periodicals; 617.9505
• DOI: 10.1016/j.bjps.2014.08.069
• Languages: English
• ISSNs: 1748-6815

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Background</title> <p id="abspara0010">Maxillary distraction osteogenesis (DO) in cleft lip and palate patients has been described by several authors, but most studies have a relatively short follow-up and do not clearly separate growing patients from non-growing patients.</p> </sec> <sec> <title id="sectitle0020">Method</title> <p id="abspara0015">The records of 22 consecutive patients affected by cleft lip and palate, who underwent Le Fort I osteotomy and maxillary distraction with a rigid external distractor (RED), were reviewed. The sample was subdivided into a growing and a non-growing group. All patients had pre-DO cephalometric records, immediately post DO, 12 months post DO and long-term records with a long-term follow-up of >5 years (range 5–13 years). As a control sample for the growing group, cleft children with a negative overjet not subjected to distraction or any protraction treatment during growth were followed up until the completion of growth.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">The average maxillary advancement in the growing group was 22.2 ± 5.5 mm (range: 15–32 mm); in the non-growing group, it was 17.7 ± 6.6 mm (range: 6–25 mm). Excellent post-surgical stability was recorded in the adult sample. On the other hand, growing children had an average 16% relapse in the first year post DO and an additional 26% relapse in the long-term follow-up.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">This study seems to point out that early Le Fort I DO allows for the correction of very severe deformities. It is followed by a relatively high amount of true skeletal relapse in children with cleft lip and palate. Prognosis should be discussed in depth with the family and true aesthetic and psychological needs assessed.</p> </sec> </abstract>