Skip to main content
SpringerLink
Log in

Rigid External Distraction: Its Application in Cleft Maxillary Deformities

  • Chapter
  • First Online:
Cleft Lip and Palate

  • 5957 Accesses

Abstract

Patients with severe maxillary deficiency secondary to orofacial clefting present multiple challenging problems for the reconstructive team. These patients exhibit multidimensional maxillary hypoplasia and skeletal clefting with absence of maxillary and alveolar bone, as well as scarring, residual fistulas, and dental anomalies. Traditional surgical/orthodontic approaches to treat these patients, while sometimes successful in obtaining stable occlusal relationships, often fall short of expectations with respect to facial balance and aesthetics. The application of maxillary distraction osteogenesis in the treatment protocol of patients with severe maxillofacial anomalies offers a powerful alternative for the reconstructive team.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Cheung LK, Sammam N, Hiu E, Tiderman H (1994) The 3-dimensional stability of maxillary osteotomies in cleft patients with residual alveolar clefts. Br J Oral Maxillofac Surg 32(1):6–12

    Article  PubMed  CAS  Google Scholar 

  • Chin M, Toth BA (1997) Le Fort III advancement with gradual distraction using internal devices (Abstract 76). International congress on cranial and facial bone distraction processes, Paris

    Google Scholar 

  • Cohen SR, Burstein FD (1997) Maxillary-midface distraction in children with cleft lip and palate: a preliminary report. Plast Reconstr Surg 99(5):1421–1428

    Article  PubMed  CAS  Google Scholar 

  • Da Silva Filho OG, Correa Normando AD, Capelozza Filho L (1993) Mandibular growth in patients with cleft lip and/or cleft palate-the influence of cleft type. Am J Orthod Dentofacial Orthop 104(3):269–275

    Article  PubMed  Google Scholar 

  • Diner PA, Martinez H, Tarbadar Y, et al (1997) Experience with distraction in maxillary deficiency at Trousseau hospital (Abstract 60). International congress on cranial and facial bone distraction processes, Paris

    Google Scholar 

  • Erbe M, Stoelinga PJW, Leenen RJ (1996) Longterm results of segmental repositioning of the maxilla in cleft palate patients without previously grafted alveolopalatal clefts. J Craniomaxillofac Surg 24(2):109–117

    Article  PubMed  CAS  Google Scholar 

  • Eskenazi LB, Schendel SA (1992) An analysis of Le Fort I maxillary advancement in cleft lip and palate patients. Plast Reconstr Surg 90(5):779–786

    Article  PubMed  CAS  Google Scholar 

  • Figueroa AA, Polley JW, Ko E (2001) Distraction osteogenesis for treatment of severe cleft maxillary deficiency with the RED technique, chap. 55. In: Sanchukov ML (ed) Craniofacial distraction osteogenesis. Mosby, St. Louis, pp 485–493

    Google Scholar 

  • Figueroa AA, Polley JW, Friede H, Ko EW (2004) Long-term skeletal stability after maxillary advancement with distraction osteogenesis using a rigid external distraction device in cleft maxillary deformities. Plast Reconstr Surg 114(6):1382–1392

    PubMed  Google Scholar 

  • Hierl T, Hemprich A (1999) Callus distraction of the midface in the severely atrophied maxilla: a case report. Cleft Palate Craniofac J 36:457

    Article  PubMed  CAS  Google Scholar 

  • Hochban W, Gans C, Austermann KH (1993) Longterm results after maxillary advancement in patients with clefts. Cleft Palate Craniofac J 30(2):237–243

    Article  PubMed  CAS  Google Scholar 

  • Houston WJ, James DR, Jones E, Kawadia S (1989) Le Fort I maxillary osteotomies in cleft palate cases. J Craniomaxillofac Surg 17(1):9–15

    Article  PubMed  CAS  Google Scholar 

  • Hung KF, Lin WY, Huang CS, Chen KT, Lo LJ (1997) The maxillary movement distraction: preliminary results (Abstract 55). International congress on cranial and facial bone distraction processes, Paris

    Google Scholar 

  • Kapp-Simon K (1996) Psychological adaptation of patients with craniofacial malformations. In: Psychological aspects of facial form, Monograph no. 11, craniofacial growth series. Center for Human Growth and Development, University of Michigan, Ann Arbor, pp 143–160

    Google Scholar 

  • Molina F, Ortiz-Monasterio F (1996) Maxillary distraction: three years of clinical experience. In: Proceedings of the 65th annual meeting of the American Society of Plastic and Reconstructive Surgeons, Plastic Surgical Forum, vol XIX. p 54

    Google Scholar 

  • Polley JW, Figueroa AA (1997) Management of severe maxillary deficiency in childhood and adolescence through distraction osteogenesis with an external, adjustable, rigid distraction device. Craniofac Surg 8(3):181–185

    Article  CAS  Google Scholar 

  • Posnick JC, Dagys AP (1994) Skeletal stability and relapse patterns after Le Fort I maxillary osteotomy fixed with miniplates: the unilateral cleft lip and palate deformity. Plast Reconstr Surg 94(7):924–932

    Article  PubMed  CAS  Google Scholar 

  • Rachmiel A, Laufer D, Aizenbud D (1997) Surgically assisted orthopedic protraction of the maxilla in cleft palate patients by distraction osteogenesis (Abstract 198). American Cleft Palate-Craniofacial Association 54th annual meeting, New Orleans

    Google Scholar 

  • Rosen H (1992a) Aesthetics in facial skeletal surgery. Perspect Plast Surg 6:1

    Google Scholar 

  • Rosen HM (1992b) Facial skeletal expansion: treatment strategies and rationale. Plast Reconstr Surg 89(5):798–808

    Article  PubMed  CAS  Google Scholar 

  • Ross RB (1987) Treatment variables affecting facial growth in complete unilateral cleft lip and palate: part 7. An overview of treatment and facial growth. Cleft Palate J 24(1):5–77

    PubMed  CAS  Google Scholar 

  • Semb G (1991) A study of facial growth in patients with unilateral cleft lip and palate treated by the Oslo CLP team. Cleft Palate Craniofac J 28(1):1–21

    Article  PubMed  CAS  Google Scholar 

  • Stoelinga PJW, Van der Vijver HRM, Leenen RJ, Blijdorp PA, Schoenaers JHA (1987) The prevention of relapse after maxillary osteotomies in cleft palate patients. J Craniomaxillofac Surg 15(6):326–331

    Article  PubMed  CAS  Google Scholar 

  • Witzel MA, Vallino LD (1992) Speech problems in patients with dentofacial and craniofacial deformities. In: Bell WH (ed) Modern practice in orthognathic and reconstructive surgery, vol 3. Saunders, Philadelphia, p 1686

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Craniofacial Clinic, Rush University Medical Center, 1725 W Harrison Street, Suite 425, Chicago, IL, 60612, USA

    John W. Polley

  2. Rush Craniofacial Center, Professional Bldg. I, 1725 West Harrison Street, Suite 425, Chicago, IL, 60612, USA

    Alvaro A. Figueroa DDS, M.S.

Authors
  1. John W. Polley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alvaro A. Figueroa DDS, M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John W. Polley .

Editor information

Editors and Affiliations

  1. Paradela Street 11035, Coral Gables, 33156, Florida, USA

    Samuel Berkowitz

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Polley, J.W., Figueroa, A.A. (2013). Rigid External Distraction: Its Application in Cleft Maxillary Deformities. In: Berkowitz, S. (eds) Cleft Lip and Palate. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-30770-6_28

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-30770-6_28

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-30769-0

  • Online ISBN: 978-3-642-30770-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation