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Clinical Outcomes in Orthognathic Surgery for Craniofacial Microsomia Following Mandibular Distraction Using CBCT
Evellyn M DeMitchell-Rodriguez1, Paul A Mittermiller1, Shayna P Avinoam1
1Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.
Summary
Orthognathic surgery (OGS) after mandibular distraction osteogenesis (MDO) in craniofacial microsomia (CFM) patients yields stable outcomes. This surgical approach effectively corrects occlusal cant and chin deviation, with minimal relapse observed in long-term follow-up.
Area of Science:
- Craniofacial surgery
- Orthodontics
- Plastic surgery
Background:
- Craniofacial microsomia (CFM) presents complex challenges in facial asymmetry.
- Mandibular distraction osteogenesis (MDO) is a common initial treatment for CFM.
- Orthognathic surgery (OGS) may be required for definitive correction.
Purpose of the Study:
- To evaluate the stability and outcomes of OGS in CFM patients.
- To compare outcomes of OGS with and without prior MDO.
- To assess occlusal cant and chin point deviation changes after OGS.
Main Methods:
- Retrospective cohort study of 12 CFM patients undergoing OGS (1996-2019).
- Analysis of cone beam computed tomography (CBCT) scans at three time points (pre-OGS, post-OGS, long-term follow-up).
- Measurement of occlusal cant and chin point deviation using 3D software.
Main Results:
- Both OGS alone and OGS after MDO groups showed significant postoperative improvement.
- No statistically significant difference in occlusal cant relapse between the two groups (0.6° vs 0.7°).
- No statistically significant difference in chin point deviation relapse between the two groups (0.1 mm vs 0.7 mm).
Conclusions:
- OGS following MDO in CFM patients can achieve stable results.
- The sequence of MDO followed by OGS does not appear to compromise long-term stability.
- Further research with larger cohorts may be beneficial.
