Hierl T, Hemprich A
Department of Oral, Maxillofacial and Plastic Surgery, University of Leipzig, Germany.
Cleft Palate Craniofac J. 1999 Sep;36(5):457-61. doi: 10.1597/1545-1569_1999_036_0457_cdotmi_2.3.co_2.
This report introduces the possibilities of callus distraction in the extremely atrophied, edentulous midface in a cleft lip and palate patient.
After a subtotal Le Fort II osteotomy, tension wires were fixed to the zygomatic buttresses and frontal sinus walls by way of titanium miniplates and mesh and connected to a rigid external distractor. Then distraction of the whole midface (1 mm/d) was performed.
Even in severe atrophy a distraction of the maxilla of 20 mm was possible. Stability has been shown for more than 5 months.
Rigid external midfacial distraction may be used in difficult cases for the correction of sagittal discrepancies where conventional orthognathic surgery is likely to be insufficient. Further investigations will concentrate on the long-term outcome.
本报告介绍了在唇腭裂患者极度萎缩、无牙的中面部进行骨痂牵张的可能性。
在进行次全Le Fort II截骨术后，通过钛微型钢板和网片将张力钢丝固定于颧支柱和额窦壁，并连接至坚固的外部牵张器。然后对整个中面部进行牵张（1毫米/天）。
即使在严重萎缩的情况下，上颌骨仍有可能牵张20毫米。已证明稳定性超过5个月。
坚固的外部中面部牵张可用于传统正颌手术可能不足的困难病例，以矫正矢状位差异。进一步的研究将集中于长期效果。
