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Related Experiment Videos

Advancement of the midface using distraction techniques

M G Cedars1, D L Linck, M Chin

  • 1Division of Plastic Surgery, Children's Hospital of Oakland, Calif, USA.

Plastic and Reconstructive Surgery
|February 9, 1999
PubMed
Summary

Le Fort III midface advancement using distraction techniques showed excellent stability at the occlusal level, with some relapse at the orbital level. Obstructive sleep apnea resolved in all affected patients, with mild speech effects and no impact on eye muscle function.

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Area of Science:

  • Craniofacial Surgery
  • Orthognathic Surgery
  • Pediatric Plastic Surgery

Background:

  • Midface hypoplasia presents significant functional and aesthetic challenges.
  • Le Fort III osteotomy is a complex procedure for midface advancement.
  • Distraction osteogenesis offers an alternative for skeletal reconstruction.

Purpose of the Study:

  • To evaluate the long-term stability of Le Fort III midface advancement via distraction.
  • To assess functional outcomes, including obstructive sleep apnea and speech.
  • To report effects on extraocular muscle function.

Main Methods:

  • Retrospective analysis of 14 patients undergoing Le Fort III distraction.
  • Cephalometric analysis of 6 patients with >1 year follow-up.

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  • Evaluation of obstructive sleep apnea, tracheostomy status, speech, and ocular motility.

    • Main Results:

    • Excellent occlusal stability achieved postoperatively.
    • Some degree of relapse noted at the orbital rim level.
    • Complete resolution or improvement of obstructive sleep apnea in all affected patients.
    • One of two patients with tracheostomy successfully decannulated.
    • Mild or transient speech alterations observed.
    • No adverse effects on extraocular muscle function.

    Conclusions:

    • Le Fort III distraction osteogenesis provides stable midface advancement, particularly at the occlusal level.
    • Significant functional improvements, including resolution of obstructive sleep apnea, are achievable.
    • The procedure is associated with minimal and transient functional complications.