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Maxillary-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia.

Hideo Nakajima1, Yoshiaki Sakamoto, Ikkei Tamada

  • 1Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ward, Tokyo 160-8582, Japan. nakajiprs@yahoo.co.jp

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|January 4, 2011
PubMed
Summary

This study introduces a novel internal distraction device for treating hemifacial microsomia, improving facial asymmetry and promoting normal growth in patients during their developmental period.

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Area of Science:

  • Craniofacial surgery
  • Orthodontics
  • Biomedical engineering

Background:

  • Hemifacial microsomia (HFM) treatment traditionally involves surgery and orthodontics.
  • Previous methods like mandibular ramus distraction had limitations in correcting occlusal plane issues and maxilla underdevelopment in Pruzansky type II HFM.
  • External distractors caused patient distress and scarring.

Observation:

  • Mandibular-driven simultaneous maxillo-mandibular distraction led to downward facial elongation and inadequate ramus lengthening.
  • Morphological issues included a flat mandibular angle and elevated oral commissure.
  • The need for active maxillary treatment was identified for optimal outcomes.

Findings:

  • A new internal distraction device with a variable angle was developed.
  • Maxillary-driven simultaneous maxillo-mandibular distraction using the new device yielded morphologically satisfactory results.
  • This approach effectively addressed limitations of previous techniques, including occlusal plane correction and reduced patient distress.

Implications:

  • The novel internal device offers improved aesthetic and functional outcomes for HFM patients.
  • Maxillary-driven distraction facilitates more predictable facial growth and skeletal correction.
  • Careful monitoring during the growth period is crucial for optimizing long-term results in HFM management.