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

Research output: Contribution to journalArticle

3 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

Fingerprint

Goldenhar Syndrome
Growth
Mixed Dentition
Chin
Therapeutics
Permanent Dentition
Orthognathic Surgery
Paralysis
Longitudinal Studies
Retrospective Studies
Recurrence
Infection

Keywords

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

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology

Cite this

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

In: Journal of Cranio-Maxillofacial Surgery, Vol. 44, No. 9, 01.01.2016, p. 1201-1208.

Research output: Contribution to journalArticle

@article{ab940d2964ef4f9dbe4c30974c56bef9,
title = "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",
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.",
keywords = "Craniofacial microsomia, Distraction osteogenesis, Early distraction, Long-term results, Separate mandibular and maxillary distractors",
author = "Lu, {Ting Chen} and Kang, {Gavin Chun Wui} and Yao, {Chuan Fong} and Liou, {Eric Jein Wein} and Ko, {Ellen Wen Ching} and Chen, {Zung Chung} and Chen, {Philip Kuo Ting}",
year = "2016",
month = "1",
day = "1",
doi = "10.1016/j.jcms.2016.07.002",
language = "English",
volume = "44",
pages = "1201--1208",
journal = "Journal of Cranio-Maxillo-Facial Surgery",
issn = "1010-5182",
publisher = "Churchill Livingstone",
number = "9",

}

TY - JOUR

T1 - Simultaneous maxillo-mandibular distraction in early adolescence as a single treatment modality for durable correction of type II unilateral hemifacial microsomia

T2 - Follow-up till completion of growth

AU - Lu, Ting Chen

AU - Kang, Gavin Chun Wui

AU - Yao, Chuan Fong

AU - Liou, Eric Jein Wein

AU - Ko, Ellen Wen Ching

AU - Chen, Zung Chung

AU - Chen, Philip Kuo Ting

PY - 2016/1/1

Y1 - 2016/1/1

N2 - 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.

AB - 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.

KW - Craniofacial microsomia

KW - Distraction osteogenesis

KW - Early distraction

KW - Long-term results

KW - Separate mandibular and maxillary distractors

UR - http://www.scopus.com/inward/record.url?scp=84994323180&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84994323180&partnerID=8YFLogxK

U2 - 10.1016/j.jcms.2016.07.002

DO - 10.1016/j.jcms.2016.07.002

M3 - Article

C2 - 27499513

AN - SCOPUS:84994323180

VL - 44

SP - 1201

EP - 1208

JO - Journal of Cranio-Maxillo-Facial Surgery

JF - Journal of Cranio-Maxillo-Facial Surgery

SN - 1010-5182

IS - 9

ER -