Simultaneous maxillo-mandibular distraction in early adolescence as a single treatment modality for durable correction of type II unilateral hemifacial microsomia: Follow-up till completion of growth

Ting Chen Lu, Gavin Chun Wui Kang, Chuan Fong Yao, Eric Jein Wein Liou, Ellen Wen Ching Ko, Zung Chung Chen, Philip Kuo Ting Chen

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5 Citations (Scopus)

Abstract

Background Timing of surgical intervention in hemifacial microsomia (HFM) is controversial. Although mandibular osteodistraction in childhood for HFM is popular, recent data for single-stage distraction in growing HFM patients demonstrated long-term relapse. Literature suggests that adolescents in the late mixed dentition age or permanent dentition age (11–16-year-old) had more stable outcomes post-distraction than younger children. We present favorable experience using single-treatment simultaneous maxillo-mandibular distraction in early adolescent Pruzansky–Kaban type II HFM patients. Methods This was a retrospective longitudinal study of seven consecutive type IIa/b HFM growing patients (12–16-year-old) treated with simultaneous maxillo-mandibular distraction. Oral commissure cant was photographically measured preoperatively and at 6 months and annually ranging 3–7 years post-distraction. Ramus height and chin deviation were measured from radiographs done preoperatively and at distractor-removal, 1 year, 2 years, and 4 years post-distraction. Results Average age at osteodistraction and at latest follow-up was 13.7 and 18.6 years, respectively. Improvement was significant (p < 0.05) and sustained for mean oral commissure cant (5.1°–0.41°), mean ramus height ratio (0.59–0.86), and average chin deviation (15.9 mm–1.2 mm). Two subjects had mandibular branch palsy and one had mild pin-tract infection – all resolved. All were satisfied with their facial appearance. Conclusion We have demonstrated good lasting outcomes at completion of growth with single-stage simultaneous maxillo-mandibular distraction for type II HFM adolescents in the late mixed-dentition or older age, and advocate this as an alternative to osteodistraction or orthognathic surgery upon skeletal maturity.

Original languageEnglish
Pages (from-to)1201-1208
Number of pages8
JournalJournal of Cranio-Maxillofacial Surgery
Volume44
Issue number9
DOIs
Publication statusPublished - Jan 1 2016
Externally publishedYes

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Keywords

  • Craniofacial microsomia
  • Distraction osteogenesis
  • Early distraction
  • Long-term results
  • Separate mandibular and maxillary distractors

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology

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