Is Le Fort I Distraction Enough to Treat Severe Midface Hypoplasia?. Issue 5 (July 2021)

• Record Type: Journal Article
• Authors: Goel, Pedram; Fahradyan, Artur; Wolfswinkel, Erik M.; Jacob, Laya; Yen, Stephen L-K.; Urata, Mark M.; Hammoudeh, Jeffrey A.
• Is Part Of: Journal of craniofacial surgery. Volume 32:Issue 5(2021)
• Publication Date: 2021-07
• Subjects: Internal distraction -- Le Fort I distraction -- maxillary distraction; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000007448
• Languages: English
• ISSNs: 1049-2275

Abstract

Abstract : Background: In severe cases of maxillary hypoplasia, Le Fort I distraction may be required for treatment. This study describes our experience with internal distraction devices and assesses our outcomes in patients with a negative overjet on average >15 mm. Methods: A retrospective review of patients with a history of cleft lip and/or palate who underwent Le Fort I distraction at our institution from 11/2007-11/2017 was performed. Data regarding demographics, procedural details and outcomes were collected and analyzed. Results: Twenty patients, 13 (65.0%) male and 7 (30.0%) female, were included. All (100%) patients had a history of cleft lip and/or palate and 2 (10.0%) of them had associated syndromes. All 20 patients underwent internal distraction. The average age at surgery was 17.8 years (range 15.2–20.7, SD 1.6 years). The average preoperative negative overjet was 19.27 mm (range 10–30, SD 5.63 mm). The mean total distraction length was 15.3 mm (range 0–30, SD 6.72 mm). There were no intraoperative complications, however, there were a total of 4 (20.0%) postoperative complications, 2 of which required reoperation due to device malfunction or displacement. 14 (70.0%) patients had repeat procedures to complete occlusal correction or correct relapse. Conclusions: Maxillary distraction alone was insufficient for correction of maxillary discrepancies averaging >15 mm. Instead, it's utility may be in positioning the maxilla for a more viable final advancement and fixation procedure, rather than being solely responsible for achieving normal occlusion during distraction. Abstract : Supplemental Digital Content is available in the text