Long-term follow-up of syndromic craniosynostosis after Le Fort III halo distraction: a cephalometric and CT evaluation.

Abstract

BACKGROUND:

Midface distraction osteogenesis (DO) in craniofacial synostosis (CFS) patients has been described by several authors. However, very few cephalometric and computed tomography (CT) long-term follow-up studies are available.

METHOD:

A total of 40 consecutive patients affected by CFS subjected to Le Fort III and rigid external distraction (RED) were examined. All patients had pre-DO cephalometric records, immediately post-DO and 6-12 months post-DO. Twenty-seven patients had mid-term records (3 years post-DO) and 20 patients had long-term records (5-10 years post-DO). Fourteen patients had CT data within 1-year of DO, while 10 patients had long-term CT data (range 5-9 years).

RESULTS:

Excellent post-surgical stability was recorded. Short- and long-term CT data demonstrated excellent ossification at the osteotomy sites post-DO. In the growing patients, surface resorption in the zygomatic-temporal and in the subspinal area (p < 0.05) was observed in the long-term follow-up, as well as a mild increment of the corrected exorbitism (p < 0.05), as only appositional and no sutural growth occurs post Le Fort III, whereby orbital volume does not increase after surgery.

CONCLUSION:

Significant advancement of the midface can be achieved and maintained through Le Fort III and RED. In the long term, in growing patients, in general a class III malocclusion does not re-occur, but physiological remodelling processes at the maxillary-zygomatic level, not coupled with sutural growth, tend to mildly re-express the original midfacial phenotype and the exorbitism.

• Authors: Maria Costanza Meazzini, Fabiana Allevia, Fabio Mazzoleni, Luca Ferrari, Mario Pagnoni, Giorgio Iannetti, Alberto Bozzetti, Roberto Brusati
• Journal: Journal of plastic, reconstructive & aesthetic surgery : JPRAS (J Plast Reconstr Aesthet Surg) Vol. 65 Issue 4 Pg. 464-72 (Apr 2012) ISSN: 1878-0539 [Electronic] Netherlands
• PMID: 22227504 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Topics

• Acrocephalosyndactylia (surgery)
• Adolescent
• Adult
• Cephalometry
• Child
• Child, Preschool
• Craniofacial Dysostosis (surgery)
• Craniosynostoses (diagnostic imaging, surgery)
• Female
• Follow-Up Studies
• Humans
• Infant
• Male
• Middle Aged
• Osteogenesis, Distraction
• Tomography, X-Ray Computed