Distraction osteogenesis after LFIII osteotomy in growth

Objectives: The aim of this study was to analyse the stability of midfacial advancement and the pattern of growth after Le Fort III osteotomy and distraction osteogenesis (D.O.). Methods: We performed D.O. after a Le Fort III osteotomy in 6 cases (3 patients with Crouzon S., 2 patients with Apert S. and 1 patient with Pfeiffer S.). The latency period was 5 days, the distraction rate 1 mm/die for first 12 days, than 0.5 mm/die. The consolidation period was about 60 days every 10 mm. We analyzed and superimposed Lateral Cephalometric X-Rays pre DO, immediately post DO and at the longest follow up. Results: The mean sagittal midfacial advancement was 14.5mm at the level of posterior orbitale point and 18.16mm at A point level. After 1 year follow up a mild relapse was noted (an average of 1mm at posterior orbitale and of 2.5mm at A point). Regarding post surgical growth no subsequent maxillary horizontal growth was observed (no sutural growth) and in some patients resorbitive remodelling was seen. On the other hand vertical maxillary growth was present (posterior more than anterior). Conclusions: D.O. of the midface allows for accurate planned correction of the midface deformity. The correction is acceptably stable as showed by post op X-Ray Tracing Superimposition. The original pattern of growth does not change, therefore, overcorrection is highly advised, especially in growing patients.