Midface Distraction Osteogenesis Using a Modified External Device With Elastic Distraction for Crouzon Syndrome

Area of Science:

• Craniofacial Surgery
• Orthodontics
• Pediatric Plastic Surgery

Background:

• Crouzon syndrome often presents with midface hypoplasia, leading to exophthalmos and obstructive sleep apnea.
• Midface distraction osteogenesis is a common treatment for these conditions.

Purpose of the Study:

• To present a modified external device utilizing elastic distraction for midface advancement in Crouzon syndrome.
• To analyze the clinical outcomes and skeletal changes associated with this technique.

Main Methods:

• Le Fort III osteotomy and midface advancement were performed on five Crouzon syndrome patients.
• A modified external device with a shape memory alloy spring and bone-borne hooks facilitated distraction at 1-1.5 mm/day.
• Cephalometric and CT scans analyzed skeletal changes.

Main Results:

• All patients showed improvements in midface appearance, obstructive sleep apnea, exophthalmos, and occlusion.
• One patient developed a correctable open bite; no other complications occurred.
• Differential midface advancement was observed, with greater advancement at the occlusal level than the orbital level. Bone remodeling occurred in growing patients.

Conclusions:

• The modified external device with elastic distraction is an effective alternative for midface advancement in Crouzon syndrome.
• This technique successfully addresses functional and aesthetic concerns associated with midface hypoplasia.