Distraction Osteogenesis Combinations for Patients With Severe Complicated Cleft Maxillary Hypoplasia

Cleft maxillary hypoplasia (CMH) is a common sequela in patients with cleft lip and palate (CLP) who have undergone surgical and orthodontic interventions. Le Fort I maxillary distraction osteogenesis (DO) using a halo-type external distraction device is a well-established technique for maxillary advancement. However, simple anterior advancement may not yield satisfactory outcomes in cases involving severe segmental deviations. The authors reported our success in utilizing a combination of various maxillary DO and bone transport techniques to correct severe, complicated CMH. The patient was a 13-year-old girl with Angle Class III malocclusion and a history of congenital left CLP. She had undergone prior corrective surgeries, including cheiloplasty at 3 months of age, palatoplasty at 14 months, and rhinoplasty at 5 years. Our approach achieved favorable functional and aesthetic outcomes by addressing the complex deformities between maxillary segments. This case highlights the effectiveness of various DO strategies in managing severe, complicated CMH.