[Intermediate butterfly osteotomy with rigid external distraction in Crouzon syndromes]

In Crouzon syndromes, there is an hypoplasia of the midface. An intermediate midfacial osteotomy between Lefort 2 and Lefort 3, called "butterfly osteotomy", associated wit a rigid external distraction on a Pooley helmet allows to pull the entire middle maxillary, orbital and zygomatic level in one step, and to project the tip of the nose, by a single endobuccal approach. The osteotomy concerns the entire middle level of the face while respecting the upper part of the nose. The external distractor with cranial support makes it possible to reposition the face, corrects the open bite and project the tip of the nose. This technique brings a ventilatory improvement in sleep apnea syndromes and an aesthetic improvement, beneficial on a psychological level.