Callus distraction of the midface in the severely atrophied maxilla--a case report

Abstract

Objective: This report introduces the possibilities of callus distraction in the extremely atrophied, edentulous midface in a cleft lip and palate patient.

Intervention: After a subtotal Le Fort II osteotomy, tension wires were fixed to the zygomatic buttresses and frontal sinus walls by way of titanium miniplates and mesh and connected to a rigid external distractor. Then distraction of the whole midface (1 mm/d) was performed.

Results: Even in severe atrophy a distraction of the maxilla of 20 mm was possible. Stability has been shown for more than 5 months.

Conclusions: Rigid external midfacial distraction may be used in difficult cases for the correction of sagittal discrepancies where conventional orthognathic surgery is likely to be insufficient. Further investigations will concentrate on the long-term outcome.