Euclidean distance matrix analysis of surgical changes in prepubertal craniofacial microsomia patients treated with an inverted L osteotomy

Objectives: Correction of craniofacial microsomia (CFM) presents several ch allenges concerning the modality of surgical intervention. The aim of this study was to assess early and late surgical outcome, by undertaking Euclide an distance matrix analysis (EDMA) of CFM patients exhibiting an unilateral mandibular deformity that was surgically corrected by an inverted L osteot omy and autogenous bone graft. Design: Longitudinal study. Preoperative, approximate to 1-year postoperati ve and approximate to 3-year postoperative assessments of 14 consecutive ch ildren (mean age 9 years) with CFM. Posteroanterior cephalographs were scan ned and five homologous mandibular landmarks were digitized in triplicate ( < 1% digitization error). Average mandibular geometries, scaled to an equiv alent size, were generated using a generalized rotational fit program (Proc rustes superimposition) and subjected to EDMA, Results: The mean pre- and both postoperative mandibular configurations dif fered statistically (p < .01). Early postoperative improvements in mandibul ar form were noted; increases in length arising in the treated mandibular b ody (approximate to 19%) and ramus (approximate to 13%). Comparing early an d late postoperative configurations, a decrease of approximate to 22% in th e late postoperative mandibular body length was evident, but the ramus main tained steady vertical growth (approximate to 7%). Comparing the preoperati ve and late postoperative configurations, the decrease observed in the mand ibular body on the treated side was reduced to approximate to 8% while the ramus maintained good growth (approximate to 20%) on that side. Conclusion: Mandibular morphology is improved significantly in CFM patients surgically treated by an inverted L osteotomy, but relapse in the mandibul ar body is evident after approximate to 3 years. Nevertheless, ramus growth proceeds well after the surgical reconstruction.