Comparative Study of Internal Device versus External Device in Le Fort III Distraction for Syndromic Craniosynostosis
Mariko Noto1, Daisuke Sakahara1, Masamitsu Kuwahara2
1From the Department of Plastic and Reconstructive Surgery, Osaka City General Hospital.
Plastic and Reconstructive Surgery
|August 3, 2023
Summary
Internal Le Fort III distraction devices for syndromic craniosynostosis are linked to more complications than external devices. Surgeons can use these findings to choose the best device for better patient outcomes.
Area of Science:
- Craniofacial Surgery
- Pediatric Plastic Surgery
- Orthognathic Surgery
Background:
- Le Fort III distraction is a surgical technique used to treat syndromic craniosynostosis.
- Both internal and external devices are utilized for Le Fort III distraction procedures.
- A comparative analysis of these devices is crucial for optimizing treatment outcomes.
Purpose of the Study:
- To compare the efficacy and complication rates of internal versus external devices for Le Fort III distraction in syndromic craniosynostosis.
- To identify factors influencing device-related complications and treatment success.
- To provide evidence-based guidance for surgeons selecting distraction devices.
Main Methods:
- Retrospective evaluation of 60 patients with syndromic craniosynostosis treated with Le Fort III distraction (2001-2021).
- Comparison of demographic data, surgical parameters, and complications between internal and external device groups.
- Statistical analysis to determine associations between variables like age, elongation length, and complications.
Main Results:
- External device group (32 patients): Mean age 11.7 years, mean elongation 20.0 mm; 7 complications. Recurrent Class III occlusion associated with age.
- Internal device group (28 patients): Mean age 10.4 years, mean elongation 18.7 mm; 15 complications including infections and fractures. Elongation length correlated with complications.
- Internal devices showed a significantly higher likelihood of complications, particularly infections.
Conclusions:
- Internal devices for Le Fort III distraction are associated with a higher incidence of complications compared to external devices.
- Age at surgery is a significant factor for recurrent Class III occlusion in both device types.
- Understanding the relationship between elongation length and device problems can aid in surgical decision-making and complication management.
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