An Alternative Internal Le Fort I Distractor: Early Results With a New Trans-Nasal Device

Area of Science:

• Craniofacial Surgery
• Orthognathic Surgery
• Pediatric Maxillofacial Reconstruction

Background:

• Severe maxillary deficiency is a common challenge in patients with cleft lip and palate.
• Traditional Le Fort I osteotomy and distraction may have limitations in this patient population.
• Novel internal distraction devices aim to improve outcomes and patient experience.

Purpose of the Study:

• To evaluate the early clinical outcomes of a new internal trans-nasal Le Fort I distractor.
• To assess the efficacy and safety of this device in correcting maxillary deficiency in cleft lip and palate patients.
• To document patient tolerance and complications associated with the device.

Main Methods:

• Retrospective review of five male patients with bilateral cleft lip and palate and severe maxillary deficiency.
• Cephalometric analysis preoperatively and at least 6 months postoperatively.
• Evaluation of speech outcomes and patient-reported experience, along with complication recording.

Main Results:

• Significant maxillary advancement (mean SNA 75.5° to 84.6°, mean ANB -2.8° to 7.4°) achieved with the device.
• Increase in upper anterior facial height by 7.5 mm; acceptable postoperative occlusions in all patients.
• Two patients developed postoperative velopharyngeal insufficiency; two experienced localized pin site infections, both managed successfully.

Conclusions:

• The internal trans-nasal Le Fort I distractor is an effective tool for maxillary advancement in cleft lip and palate patients.
• The device demonstrates good patient tolerance with manageable complications.
• Further investigation into speech outcomes and long-term stability is warranted.