Summary
Le Fort distraction osteogenesis is sometimes applied to improve the facial appearance
in craniofacial dysostosis or cleft lip and palate. Distraction devices are generally
classified into external and internal types. The movement of external distractors
can be controlled easily but their large size and the need for a facial mask cause
much psychological stress to the patient. Internal distractors are smaller and better
tolerated, but they are not easily controllable and removal is difficult.
We designed an internal distraction device to eliminate the problems of the currently
available distractors –Nakajima’s angle-variable internal distraction (NAVID) system
– and aimed to assess its clinical applicability. Between 2000 and 2010, we treated
16 patients with the NAVID system: Le Fort I, III, III + I and IV distractions were
performed in three, five, four and four patients, respectively. Distraction was started
after a 1-week latency period. Then, the exposed rod was cut, and the distractors
were left in place for 3 months or more as retention devices, and thereafter removed.
All patients showed satisfactory occlusion and facial aesthetics. Open bite during
the consolidation period was the main complication.
In conclusion, the NAVID system is safe, effective and reliable for all types of Le
Fort distraction osteogenesis.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Rigid external distraction: its application in cleft maxillary deformities.Plast Reconstr Surg. 1998; 102: 1360-1372
- Direct skeletal traction for Le Fort I halo distraction replacing an intraoral dental splint and connecting traction hook.Ann Plast Surg. 2004; 53: 348-352
- Distraction osteogenesis of the hypoplastic midface using a rigid external distraction system: the results of a one- to six-year follow-up.Plast Reconstr Surg. 2006; 118: 1201-1212
- Distraction osteogenesis in maxillary deficiency using a rigid external distraction device.Plast Reconstr Surg. 2006; 117: 2399-2406
- Introduction of an intraoral bone-lengthening device.Plast Reconstr Surg. 1995; 96: 978-981
- Internal maxillary distraction with a new bimalar device.J Oral Maxillofac Surg. 2008; 66: 675-683
- Introduction of a new removable adjustable intraoral maxillary distraction system for correction of maxillary hypoplasia.J Craniofac Surg. 2009; 20: 1776-1786
- Le Fort III advancement with gradual distraction using internal devices.Plast Reconstr Surg. 1997; 100: 819-830
- The Le Fort III osteotomy: to distract or not to distract?.Plast Reconstr Surg. 2001; 107: 1091-1103
- How to revise and utilise the cephalogram for craniofacial dysostosis - modification of the porion and the McNamara line.J Craniomaxillofac Surg. 2010; 38: 441-451
- Skeletal stability and relapse patterns after Le Fort I maxillary osteotomy fixed with miniplates: the unilateral cleft lip and palate deformity.Plast Reconstr Surg. 1994; 94: 924-932
- Factors related to relapse after Le Fort I maxillary advancement osteotomy in patients with cleft lip and palate.Cleft Palate Craniofac J. 2001; 38: 1-10
- Intra- and perioperative complications of the LeFort I osteotomy: a prospective evaluation of 1000 patients.J Craniofac Surg. 2004; 15: 971-977
- Craniofacial distraction osteogenesis: a review of the literature: Part 1: clinical studies.Int J Oral Maxillofac Surg. 2001; 30: 89-91
Aspinall C, Hopper R, Andrews M. What the parents and patients don’t tell you—Recollections following external device Le Fort distractions. American Cleft Palate-Craniofacial Association 61st Annual Meeting; 2004 March 15–20, 2004; Chicago, IL; 2004, p 6.
- Complications in maxillary distraction using the RED II device: a retrospective analysis of 21 patients.Int J Oral Maxillofac Surg. 2006; 35: 897-902
Article info
Publication history
Published online: September 07, 2011
Accepted:
August 2,
2011
Received:
May 16,
2011
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
