A Technical Innovation in Midface Advancement With the External Frame Distraction Device

Area of Science:

• Oral and Maxillofacial Surgery
• Craniofacial Surgery
• Biomedical Engineering

Background:

• Maxillary advancement using rigid external distractor (RED) II is standard for midface hypoplasia.
• Looped transpyriform wire is a simple, cost-effective anchoring method.
• Wire cut-through at the pyriform buttress is a common complication, especially in cleft patients requiring higher distraction forces due to scarring.

Purpose of the Study:

• To introduce and evaluate a novel interface to prevent traction wire complications during maxillary distraction.
• To improve the reliability of the RED II device in cleft patients.

Main Methods:

• A single-hole titanium plate was designed as an interface between the pyriform buttress bone and the traction wire.
• A retrospective comparison was made between 24 patients treated before the innovation and 26 patients treated after its introduction.

Main Results:

• The complication rate of traction wire cut-through decreased from 12.5% in the pre-innovation group to 3.8% in the post-innovation group.
• The titanium plate interface demonstrated a significant reduction in complications.

Conclusions:

• The titanium plate eyelet serves as a simple yet effective interface, enhancing the reliability of maxillary distraction with the RED II device.
• This technical addition is particularly beneficial for cleft patients with extensive scarring, ensuring more dependable midface advancement.