Le fort III midface advancement with external craniofacial distraction: critical review and our experience

The present is a retrospective study on the stability of Le Fort III midface advancement with distraction in craniofacial dynostosis. Twenty-six surgical procedures for midface advancement were performed between 2000 and 2009. Fourteen consecutive patients who underwent Le Fort III osteotomy with midface advancement using a rigid external distraction device (Synthes) in the department of Maxillo-Facial Surgery of the University "Sapienza" of Rome. In this study eight patients (n= 3 females. n= 5 males) affected by craniofacial dysostosis (5 Crouzon, 3 Apert, 1 Pfeiffer syndrome and 1 other) were selected on the basis of age and radiological documentation. The mean age at the time of the procedure was 8.6 years and all the patients had at least 1 year of follow-up after distraction. Bone growth after midface advancement is limited and, as reported in the literature, almost no spontaneous growth is present due to the intrinsic nature of malformations.