Abstract
The purpose of this study was to evaluate human mandibular lengthening by gradual distraction. The operation was performed under nasoendotracheal anesthesia. After exposing the angle of the mandible through an intraoral incision, two half-pins were inserted on each side of the corticotomy line. Following this, a corticotomy was performed using a sagittal saw, and the mandible was gently fractured. The external bone lengthening device was applied leaving a bone gap of 3 mm. Serial distraction of 1 mm per day was started on the 10th postoperative day. The device was left in place for retention purposes for 9–11 weeks. Three patients (average age 10 years and 3 months) underwent this procedure. The distraction achieved was 19 mm. Postoperatively, improvement of facial asymmetry and increased volume and length of the mandible were noted without any perioperative complications. The follow-up period averaged 13 months. These results suggested that this procedure is beneficial for the treatment of craniofacial microsomia.
Similar content being viewed by others
References
Constantino PD; Shybut G, Friedman CD, Pelzer HJ, Masini M, Shindo ML, Sisson GA (1990) Segmental mandibular regeneration by distraction osteogenesis: an experimental study. Arch Otolaryngol Head Neck Surg 116:532–545
De Bastiani G, Aldegheri R, Renizi-Brivio L, Trivella G (1987) Limb lengthening by callus distraction (callotasis). J Pediatr Orthop 7:129–134
Guyuron B, Lasa Jr CI (1991) Unpredictable growth pattern of costochondral graft. Plast Reconstr Surg 98:880–889
Ilizarov GA (1989) The tension-stress effect on the genesis and growth of tissues: Part I. The influence of stability of fixation and soft tissue preservation. Clin Orthop 238:249–281
Ilizarov GA (1989) The tension-stress effect on the genesis and growth of tissues: Part II. The influence of the rate and frequency of distraction. Clin Orthop 239:263–285
Karaharju-Suvanto T, Karaharju EO, Ranta R (1990) Mandibular distraction: an experimental study on sheep. J Craniomaxillofac Surg 18:280–283
Karp NS, Thorne CHM, McCarthy JG, Sissons HA (1990) Bone lengthening in the craniofacial skeleton. Ann Plast Surg 24:231–237
Karp NS, McCarthy JG, Schreiber JS, Sissons HA, Thorne CHM (1992) Membranous bone lengthening: a serial histological study. Ann Plast Surg 29:2–7
Kojimoto H, Yasui N, Goto T, Matsuda S, Shimomura Y (1988) Bone lengthening in rabbits by callus distraction: the role of periosteum and endosternum. J Bone Joint Surg [Br] 78:543–549
Matev IB (1970) Thumb reconstruction after amputation at the interphalangealjoint by bone lengthening. J Bone Joint Surg [Am] 52:957–965
McCarthy JG, Grayson BH, Coccaro PJ, Wood-Smith D (1990) Craniofacial microscomia. In: McCarthy JG (ed) Plastic surgery. Saunders, Philadelphia, 4:3053–3100
McCarthy JG, Schreiber J, Karp NS, Thorne CH, Grayson BH (1993) Lengthening the human mandible by gradual distraction. Plast Reconstr Surg 89:1–8
Michieli S, Miotti B (1977) Lengthening of mandibular body by gradual surgical-orthodontic distraction. J Oral Surg 35:187–192
Obwegeser HL (1974) Correction of the skeletal anomalies of oto-mandibular dysostosis. J Maxillofac Surg 2:73–92
Persing JA, Babler WJ, Nagorsky MJ, Edgerton MT, Jane JA (1986) Skull expansion in experimental craniosynostosis. Plast Reconstr Surg 78:594–603
Rachmiel A, Potparic Z, Jackson IT, Sugihara T, Clayman L, Topf JS, Forte RA (1993) Midface advancement by gradual distraction. Br J Plast Surg 46:201–207
Remmler D, McCoy FJ, O'Neil D, Willoughby L, Patterson B, Gernald K, Morris DC (1992) Osseous expansion of the cranial vault by craniotasis. Plast Reconstr Surg 89:787–797
Snyder CC, Levine GA, Swanson HM, Browne Jr EZ (1973) Mandibular lengthening by gradual distraction: preliminary report. Plast Reconstr Surg 51:506–508
Vargervic K, Kaban LB (1992) Hemifacial microsomia: diagnosis and treatment. In: Bell WH (ed) Modern practice in orthognathic and reconstructive surgery. Saunders, Philadelphia 2:1533–1560
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sugihara, T., Kawashima, K., Igawa, H. et al. Mandibular lengthening by gradual distraction in humans. Eur J Plast Surg 18, 7–10 (1995). https://doi.org/10.1007/BF00183690
Issue Date:
DOI: https://doi.org/10.1007/BF00183690