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The Versatility of Distraction Osteogenesis in Craniofacial Surgery
Mario J. Imola, MD, DDS, FRCSC;
David D. Hamlar, MD, DDS;
Gentry Thatcher, MD;
Khalid Chowdhury, MD, FRCSC
Arch Facial Plast Surg. 2002;4:8-19.
Objectives To review our preliminary results using distraction osteogenesis for
the correction of craniofacial deformities and to determine its role in treating
anatomic deformities and functional deficits relative to conventional craniofacial
surgery.
Design and Setting Retrospective clinical review; tertiary care center.
Methods Twenty-four consecutive patients were treated with distraction osteogenesis
during a 34-month period. Outcomes were compared with preexisting anatomic
deformities and functional deficits using records of clinical assessments,
photodocumentation, diagnostic imaging, and treatment planning aids.
Main Outcome Measures Distraction achieved vs planned distraction based on clinical and radiographic
assessment, clinical status of functional deficits before and after treatment,
and objective rating of aesthetic improvement.
Conclusions Preliminary results demonstrated good-to-excellent outcome in correcting
facial skeletal deformity in 80% of patients. Functional outcomes included
resolution or significant improvement of upper airway obstruction in 13 of
14 patients and correction of corneal exposure for all 5 patients with preexisting
exorbitism. Correction of malocclusion was less reliable. Problems related
to the distraction devices, including failure of the advancement mechanism
and fixation, were the most prevalent complications. Distraction osteogenesis
represents an exciting new development in craniofacial surgery with several
potential benefits, including less invasive surgery, the ability for earlier
intervention, and the potential for correction of more severe deformities
with improved posttreatment stability. The exact role of distraction osteogenesis
relative to conventional techniques requires ongoing assessment.
From the Craniofacial–Skull Base Center, Denver, Colo (Drs Imola
and Chowdhury); the Department of Otolaryngology–Head and Neck Surgery,
University of Colorado, Denver (Drs Imola and Chowdhury); and the Department
of Otolaryngology–Head and Neck Surgery, Division of Facial Plastic
and Reconstructive Surgery, University of Minnesota, Minneapolis (Drs Imola,
Hamlar, and Thatcher).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Changing Perspectives in Cleft Lip and Palate: From Acrylic to Allele
Tollefson et al.
Arch Facial Plast Surg 2008;10:395-400.
ABSTRACT
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