Management of Severe Cleft and Syndromic Midface Hypoplasia

Distraction osteogenesis has become an alternative treatment to treat severe craniofacial skeletal dysplasias. A rigid external distraction device has been successfully used to advance the maxilla as well as the maxillary, orbital, and forehead complex (monobloc) in children as young as 2 years, adolescents, and adults. This approach has provided reduced morbidity, and predictable and stable results in this challenging group of patients. With the experience gained, the technique has been successfully applied to patients with isolated dentofacial deformities. Distraction techniques can be applied by themselves or as an adjunct to conventional orthognathic and craniofacial surgical procedures.