MAXILLARY GROWTH IN CHILDREN AFTER EARLY FACIAL BIPARTITION

Facial osteotomies performed in young children are frequently associat ed with growth deficiencies, especially at the middle third of the fac e. This problem may be more severe when the initial deformity is assoc iated with alveolar and palatal clefts, Orbital hypertelorism is a maj or congenital malformation requiring early correction. The resection o f the ethmoid tissues located between the orbit and the medialization of the orbital skeleton through the intracranial approach modifies the exaggerated interorbital distance but does not correct the vertical s hortness at the midline of the face. Also this procedure interferes wi th the sagittal growth of the maxilla possibly resulting from the hori zontal osteotomy across the maxillae. The medial rotation of the two h alves of the face performed by the intracranial approach or the subcra nial approach simultaneously corrects the orbital hypertelorism and el ongates the nose and the central segment of the face. Our experience w ith this procedure in infants and young children is analyzed. A series of nine patients with orbital hypertelorism associated with median an d paramedian clefts underwent correction by hemifacial rotation. All p atients were monitored from 6 to 10 years (mean, 7 years) and demonstr ated normal sagittal growth of the maxillae.