Faculty Collaboration Database

"Cat's cradle" midfacial fixation in distraction osteogenesis after Le Fort III osteotomy. J Craniofac Surg 2004 Nov;15(6):946-52

Date

11/18/2004

Pubmed ID

15547380

DOI

10.1097/00001665-200411000-00011

Scopus ID

2-s2.0-85026150443 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

Distraction osteogenesis has provided a powerful technique for the treatment of severe midfacial hypoplasia. Skeletal fixation is a critical component of successful distraction osteogenesis. This is a report on the development of a new approach to bone fixation for distraction osteogenesis of the midface, based on circumferential suspension of the entire midfacial skeleton using surgical wires placed through the soft palate. This technique offers the advantages of (1) complete control of the attitude of the midface in terms of a precise dispersion of forces that can determine the desired pitch, yaw, and roll of this skeletal complex during the active phase of distraction, (2) being compatible with young children in the deciduous dentition stage because it obviates the need for rigid fixation devices on the maxillary lateral walls in the proximity of numerous dental follicles of the unerupted adult dentition, (3) actually serving as the instrument for posterior maxillary "lift" in cases of skeletal open bite malocclusions (frequently seen in the craniosynostoses), thereby allowing the clinician to determine the final occlusal and palatal planes and simultaneously close the open bite. An illustrative case of a 5(1/2)-year-old girl with Apert syndrome is presented wherein her ventilatory obstruction and ocular proptosis were significantly improved.

Author List

Havlik RJ, Seelinger MJ, Fashemo DV, Hathaway R

Author

Robert Havlik MD Chair, Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acrocephalosyndactylia
Child, Preschool
Dental Stress Analysis
Exophthalmos
Facial Bones
Female
Humans
Jaw Fixation Techniques
Open Bite
Osteogenesis, Distraction
Osteotomy, Le Fort
Sleep Apnea, Obstructive