Purpose: To measure the upper airway changes associated with maxillary distraction osteogenesis in cleft lip and palate patients in the immediate post operative period and 12 months later. Materials and Methods: Seven...Purpose: To measure the upper airway changes associated with maxillary distraction osteogenesis in cleft lip and palate patients in the immediate post operative period and 12 months later. Materials and Methods: Seven patients with repaired cleft lip and palate (CLP) presented with severe maxillary hypoplasia. They were examined initially at T1 predistraction phase. Records taken included radiographs (orthopantograms OPG, lateral cephalometric, posteroanterior). Cephalometric analysis was done to evaluate the upper airway. Mean age is 17 years and the reverse overjet > 6 mm. They underwent maxillary Le Fort I distraction using external rigid distracters (RED). Cephalometric analysis to evaluate the upper airway was repeated at the end of the consolidation phase T2 and twelve months after distractor removal T3. Results: The range of maxillary advancement was between 8 - 15 mm (mean 9 mm). The anteroposterior distance of the superior velopharynx (PPS) and middle velopharynx (SPPS) increased at T2. A small amount of reduction in these values was recorded at T3. The inferior velopharynx (MPS) and the oropharynx (IPS, EPS) showed minimum increase in anteroposterior distance in only two patients at T2 and no change at T3. Conclusion: All seven patients showed clinical improvement in the upper airway and an increase in the upper airway values on lateral cephalometric radiographs.展开更多
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 r...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.展开更多
文摘Purpose: To measure the upper airway changes associated with maxillary distraction osteogenesis in cleft lip and palate patients in the immediate post operative period and 12 months later. Materials and Methods: Seven patients with repaired cleft lip and palate (CLP) presented with severe maxillary hypoplasia. They were examined initially at T1 predistraction phase. Records taken included radiographs (orthopantograms OPG, lateral cephalometric, posteroanterior). Cephalometric analysis was done to evaluate the upper airway. Mean age is 17 years and the reverse overjet > 6 mm. They underwent maxillary Le Fort I distraction using external rigid distracters (RED). Cephalometric analysis to evaluate the upper airway was repeated at the end of the consolidation phase T2 and twelve months after distractor removal T3. Results: The range of maxillary advancement was between 8 - 15 mm (mean 9 mm). The anteroposterior distance of the superior velopharynx (PPS) and middle velopharynx (SPPS) increased at T2. A small amount of reduction in these values was recorded at T3. The inferior velopharynx (MPS) and the oropharynx (IPS, EPS) showed minimum increase in anteroposterior distance in only two patients at T2 and no change at T3. Conclusion: All seven patients showed clinical improvement in the upper airway and an increase in the upper airway values on lateral cephalometric radiographs.
文摘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.
