FRONTOFACIAL OSTEOTOMIES, ADVANCEMENT, AND REMODELING BY DISTRACTION - AN EXTENDED APPLICATION OF THE TECHNIQUE

The purpose of this clinical report is to present the distraction tech nique for advancement of the frontofacial skeleton as a unit. Our 14-y ear-old patient was diagnosed with Carpenter's syndrome and kleblattsc hadel deformity at birth. At other centers the patient underwent corre ctive surgeries, including repeated fronto-orbital advancement in an a ttempt to correct the residual deformity. This has resulted in bony ma lunion and recurrent deformity, and it has left the patient with no av ailable donor sites for harvesting of bone graft. The patient had clas s III malocclusion, severe midfacial and frontal deficiency, and relat ive turricephaly. We performed frontofacial osteotomies and placement of the distraction devices, Distraction of 20 mm was accomplished, cor recting the exophthalmos and midface retrusion and producing class I d ental occlusion. We conclude that distraction is an optional surgical method that can be applied in selected cases for advancement of the en tire frontofacial skeleton.