Fig 2 - uploaded by Andrés Gómez-Delgado
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Diagram showing surgical approaches (green lines), Le Fort III osteotomies (red lines), tunneling dissection (blue dashed lines), and placement of the distractor.
Source publication
Distraction osteogenesis is widely used in the treatment of craniofacial deformities when external or internal distraction devices are placed after the corresponding osteotomies. The external system is most common as it is possible to adjust it to correct the distraction vectors. Internal devices, however, are better accepted by patients, as they m...
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Purpose:
Cleft lip and palate (CLP) patients often require orthognathic surgical correction due to maxillary hypoplasia secondary to primary surgeries, through either distraction osteogenesis (DO) or conventional orthognathic surgery (CO). The objective was to evaluate both surgical techniques regarding functional, aesthetics and quality-of-life a...
Posterior cranial vault distraction osteogenesis (PVDO) is evolving as one of the first-line treatments in managing craniosynostosis. Intraoperative decision for sites of osteotomies requires precise planning and accurate placement of distractors.
Objective:
This technique helps in determining and confirming the pre-surgical planned osteotomy sit...
Citations
... For sub-condylar necks, approaches such as retromandibular, sub-mandibular, periangular, or intra-oral are preferred [2]. The modified endaural approach has already been widely documented for temporomandibular joint surgery and has even been used in combination with other approaches for the distraction of the middle third offering excellent aesthetic results and easy to perform [3]. ...
Throughout history, several authors have extensively modified approaches to temporomandibular joint surgery to improve access, improve aesthetics, and decrease the risk of nerve damage. In this report, we propose the reduction of a medial condylar fracture through the modified endaural approach, being a safe approach for the facial nerve, effective, aesthetic, and simple to perform.
... They also allow modification and better control of the distraction vector. [6,15,16] When an extraoral device is used, further surgery is not needed to remove the distractor. [6,17] This study aimed to overcome some of these limitations by modifying the method by which facial bones are anchored to an extraoral distraction device, specifically RED II. ...
Aim: Maxillofacial surgery has always aimed to find alternative therapies to treat severe maxillary hypoplasia. Distraction osteogenesis of the midface has become the technique with the best functional and aesthetic results. Nevertheless, anchoring a distractor to the middle third of the face continues to involve complex planning. Plus, achieving the desired force vector can sometimes be cumbersome and uncomfortable. The aim of this study is to propose a novel skeletal anchorage technique for the rigid external distractor.
Methods: Non-controlled, prospective study of 9 patients with severe midface hypoplasia who were treated with distraction osteogenesis using a rigid external distractor anchored to the infraorbital rims and the bilateral pyriform apertures. The activation phase started the first postoperative day at a rate of 1 mm per day. The consolidation period lasted 6 to 8 weeks.
Results: Eight patients achieved the desired distraction objective (24.5 mm on average), with only 1 suffering a 5-mm relapse. None of the patients reported complications.
Conclusion: Distraction osteogenesis of the midface by skeletal anchorage is an alternative method when treating patients with severe maxillary hypoplasia. It has significant advantages compared to traditional anchoring because it simplifies the procedure, diminishes the costs and complications.
