Two-stage maxillary distraction osteogenesis using a modified external device: clinical outcome and complications

Area of Science:

• Craniofacial Surgery
• Orthognathic Surgery
• Maxillofacial Reconstruction

Background:

• Severe maxillary hypoplasia often requires complex surgical correction.
• Rigid external distraction is a common treatment modality.
• A modified two-stage approach combining distraction and fixation was investigated.

Purpose of the Study:

• To present clinical outcomes and complications of a two-stage surgical approach for maxillary hypoplasia.
• To evaluate maxillofacial morphology changes using lateral cephalograms.
• To assess the impact on velopharyngeal function.

Main Methods:

• Retrospective study of eight patients with cleft lip and palate treated from 2016-2018.
• Two-stage surgery: maxillary distraction followed by maxillary fixation.
• Analysis of lateral cephalograms at multiple time points and speech therapy evaluation.

Main Results:

• Significant maxillary advancement (12.0mm forward, 8.0mm downward at Point A).
• Mean relapse of 24.3% horizontally and 52.5% vertically at one year.
• No significant change in velopharyngeal function; improved mouth opening post-fixation.

Conclusions:

• The modified two-stage distraction and fixation method offers advantages like shorter distractor wear and improved patient acceptance.
• The technique provides sufficient midface advancement for severe maxillary hypoplasia.
• The approach is effective without compromising velopharyngeal function.