Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ward, Tokyo 160-8582, Japan.
J Plast Reconstr Aesthet Surg. 2012 Jan;65(1):61-7. doi: 10.1016/j.bjps.2011.08.009. Epub 2011 Sep 3.
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.
牵引成骨术有时用于改善颅面发育不全或唇腭裂患者的面部外观。牵引器通常分为外固定和内固定两种类型。外固定器的移动容易控制，但体积大，需要戴面罩，这给患者带来很大的心理压力。内固定器较小，患者更容易耐受，但不易控制，取出也比较困难。我们设计了一种内固定器来解决目前可用的牵引器的问题——中嶋角度可变内牵引（NAVID）系统，并旨在评估其临床适用性。2000 年至 2010 年间，我们使用 NAVID 系统治疗了 16 例患者：分别有 3 例、5 例、4 例和 4 例患者进行了 Le Fort I、III、III+I 和 IV 型牵引。潜伏期 1 周后开始牵引。然后，暴露的杆被切断，将牵引器作为保持器放置 3 个月或更长时间，然后取出。所有患者的咬合和面部美学均得到满意改善。在愈合期，开咬是主要并发症。总之，NAVID 系统对于所有类型的 Le Fort 牵引成骨术都是安全、有效和可靠的。
