Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Stomatology, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Sci Rep. 2018 Jul 2;8(1):9948. doi: 10.1038/s41598-018-28068-8.
Rigid external distraction is currently performed to correct cases of severe maxillary hypoplasia. As an improvement of this technique, we propose the use of an intranasal bone-borne traction hook. This study is a retrospective chart review of the intranasal bone-borne traction hooks used in the treatment of severe maxillary hypoplasia. There were 110 patients treated with the hooks from 2005 to 2017. The maximum traction force was 7.75 kg, and there were few complications encountered during distraction. There were 76 patients who had the hooks removed under local anaesthesia. A cephalometric analysis was conducted in 56 patients. The average advancement of A-point was 9.9 ± 4.2 mm, 8.4 ± 2.5 mm, 11.0 ± 3.7 mm, 17.9 ± 4.4 mm for the trans-sutural distraction osteogenesis (DO), maxillary anterior segment DO, Le Fort I osteotomy DO and Le Fort III/II osteotomy DO, respectively. The average changes of sella-nasion-point A (SNA) were 8.89 ± 4.30 degrees, 8.21 ± 3.17 degrees, 10.49 ± 3.26 degrees, and 15.10 ± 4.00 degrees, respectively. The A point-nasion-B point (ANB) also showed increases in all procedures with P < 0.001. In conclusion, this technique sufficiently advances the midface and ensures the scars are concealed in the nasal base. The traction hook can bear a large traction force, causes minimal complications and is easily removed.
目前采用硬性外牵引来矫正严重上颌发育不全。作为对该技术的改进，我们提出使用经鼻骨内牵引钩。本研究回顾性分析了 2005 年至 2017 年间使用经鼻骨内牵引钩治疗严重上颌发育不全的 110 例患者。最大牵引力为 7.75kg，牵引过程中并发症较少。76 例患者在局部麻醉下取出牵引钩。对 56 例患者进行了头影测量分析。A 点的平均前徙量分别为经缝牵引成骨术（DO）、上颌前段 DO、Le Fort I 截骨术 DO 和 Le Fort III/II 截骨术 DO 的 9.9±4.2mm、8.4±2.5mm、11.0±3.7mm 和 17.9±4.4mm。蝶鞍点 A（SNA）的平均变化分别为 8.89±4.30 度、8.21±3.17 度、10.49±3.26 度和 15.10±4.00 度。所有手术中 A 点-前鼻棘点-B 点（ANB）也均有增加，P 值均<0.001。总之，该技术可充分前徙上颌骨，并确保疤痕隐藏在鼻基底。牵引钩可承受较大的牵引力，引起的并发症较少，且易于取出。
