Distraction osteogenesis of the maxilla and midface using a subcutaneous device: report of four cases

The use of distraction osteogenesis in the hypoplastic maxilla and midface is still controversial. Since the beginning of 1998, 25 patients have been treated with osteodistraction techniques for various reasons. Among them we re four patients who were treated by high LeFort I osteotomies and insertio n of a newly developed subcutaneous distraction device in the malar region. Distraction osteogenesis was successful in all four cases resulting in a m ean sagittal bone gain of 12.0 mm (range 7-14) at the level of distracter f ixation. All patients were kept under orthodontic supervision during osteod istraction. The final occlusal relation was satisfactory. Cephalometric mea surements after distraction showed an anterior rotational movement of the m idface region. As the question of relapse and further growth is still not c lear, Delaire masks are used to stabilize the surgical result after removal of the distracter. The importance of long-term follow-up is stressed. (C) 2001 The British Association of Oral and Maxillofacial Surgery.