Maxillary distraction resulting in facial advancement at Le Fort III level in cleft lip and palate patients: a report of two cases

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Nov;98(5):541-5. doi: 10.1016/j.tripleo.2004.02.066.

Abstract

An 18-year-old female and a 14-year-old male who had previously received surgery for primary repair of a nonsyndromic cleft lip and palate (including alveolar defect bone grafting) unintentionally developed facial advancement at the Le Fort III level after surgical correction of their maxillary hypoplasia. The Le Fort I osteotomy, originally performed for their maxillary dentoalveolar hypoplasia, was an incomplete osteotomy. It was performed without down-fracture, leaving the pterygomaxillary and septal junctions intact. The gradual advancement of the maxilla during distraction osteogenesis was planned to correct the hypoplastic maxilla, and also prevent subsequent hypernasality; however, during the distraction procedure by means of a rigid external device both patients developed an unintentional facial advancement at the Le Fort III level.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Bone Transplantation
  • Cleft Lip / surgery*
  • Cleft Palate / surgery*
  • Enophthalmos / etiology
  • Facial Bones / pathology*
  • Female
  • Follow-Up Studies
  • Frontal Bone / pathology
  • Humans
  • Male
  • Maxilla / abnormalities
  • Maxilla / surgery*
  • Nasal Bone / pathology
  • Nasal Septum / pathology
  • Osteogenesis, Distraction / adverse effects*
  • Osteogenesis, Distraction / methods
  • Osteotomy, Le Fort / classification
  • Osteotomy, Le Fort / methods
  • Sphenoid Bone / pathology
  • Zygoma / pathology