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Updated: Jul 23, 2026
A Mouse Distraction Osteogenesis Model
Published on: November 14, 2018
Mandibular Distraction Osteogenesis in Children with Hemifacial Microsomia: A 5-Year Follow-Up of a Prospective
Wenyi Huang1, Yingjie Yan1, Ziwei Zhang1,2
1From the Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital.
Background:
Mandibular distraction osteogenesis (MDO) is commonly used to treat hemifacial microsomia (HFM); however, its long-term efficacy, particularly on maxillary growth, remains unclear. Preliminary studies have suggested that early MDO in children may result in better outcomes. This 5-year follow-up study evaluated the long-term effects of early MDO on maxillary growth and facial symmetry.
Methods:
A 5-year follow-up was conducted in patients who participated in a prospective cohort study. Patients were divided into group A (surgical age 1 to 3 years) and group B (surgical age 4 to 6 years). Three-dimensional computed tomography data were analyzed. Symmetry was assessed using occlusal plane canting (∠OP) and the symmetry index (affected/unaffected side), and maxillary growth was evaluated using volume and linear measurements. Correlation analysis was performed to explore the relationship between mandibular distraction and maxillary growth.
Results:
A total of 24 patients completed the 5-year follow-up, with 11 patients in group A and 13 patients in group B. Patients in group A showed significant and sustained improvements in facial symmetry and maxillary compensatory growth compared with patients in group B. The ∠OP in group A decreased from 4.40 degrees preoperatively to 2.23 degrees postoperatively, with little relapse to 2.51 degrees at 5 years; patients in group B showed less favorable changes. Correlation analysis confirmed a strong relationship between mandibular vertical extension and maxillary growth.
Conclusions:
Early MDO in children with HFM was demonstrated to be safe and effective, with significant improvements in facial symmetry over a 5-year follow-up period. Further studies are warranted to evaluate the longitudinal outcomes of MDO in 1- to 3-year-old patients with HFM.
Insights
Early mandibular distraction osteogenesis (MDO) in toddlers with Hemifacial Microsomia (HFM) significantly improves facial symmetry and maxillary growth over five years. This early intervention offers sustained benefits compared to later MDO procedures.
Area of Science:
- Craniofacial surgery
- Orthodontics
- Pediatric plastic surgery
Background:
- Mandibular Distraction Osteogenesis (MDO) is a standard treatment for Hemifacial Microsomia (HFM).
- The long-term impact of MDO on maxillary development and facial symmetry is not fully understood.
- Early MDO in toddlers may yield superior outcomes.
Purpose of the Study:
- To assess the five-year efficacy of early MDO on maxillary growth and facial symmetry in HFM patients.
- To compare outcomes between early (1-3 years) and later (4-6 years) MDO intervention.
- To investigate the correlation between mandibular distraction and maxillary growth.
Main Methods:
- A five-year follow-up of a prospective cohort study involving HFM patients.
- Patients were stratified into two groups based on surgical age: Group A (1-3 years) and Group B (4-6 years).
- 3D CT analysis evaluated facial symmetry (occlusal plane canting, symmetry index) and maxillary growth (volume, linear measurements).
Main Results:
- Group A (early MDO) demonstrated significant, sustained improvements in facial symmetry and maxillary compensatory growth compared to Group B.
- Occlusal plane canting improved from 4.40° to 2.23° postoperatively and remained stable at 2.51° at five years in Group A.
- Correlation analysis revealed a strong association between mandibular vertical extension and enhanced maxillary growth.
Conclusions:
- Early MDO in toddlers with HFM is a safe and effective treatment, yielding significant five-year improvements in facial symmetry.
- Further research is recommended to explore the long-term outcomes of MDO in very young HFM patients (1-3 years).
