Temporal articular tubercle as a support of craniofacial distraction

Craniomaxillofacial monobloc or segmental distractions are effective procedures to correct retruded maxilla, especially in patients with airway obstruction and feeding difficulties or severe craniofaciostenosis and orbitostenosis with corneal problems. Several bone distraction devices have been described--external and subcutaneous--and fixed to the calvaria with miniscrews. Searching for an area of firm, safe posterior support on the calvaria to locate the miniscrews, we chose the temporal articular tubercle and the anterior root of the zygomatic arch. It is thick enough to receive screws and support the pressure of the distraction.