Private Practice.
Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Brazil.
J Craniofac Surg. 2021;32(2):e195-e198. doi: 10.1097/SCS.0000000000007101.
Distraction osteogenesis (DO) is a highly effective technique for correction of severe maxillary hypoplasia, especially in patients with orofacial clefts and craniofacial syndromes. The purpose of this retrospective, longitudinal study was to assess long-term airway alterations after maxillary advancement using a rigid external distraction system (RED) in non growing cleft patients. Fifteen cleft patients (8 males and 7 females) aged from 14 to 25 years were included in this study. All of them were treated with a rigid external distraction system for maxillary advancement after a high Le Fort I osteotomy. To analyse airway changes lateral cephalograms were obteined before distraction (T0), immediately after distraction (T1) and 1 to 3 years and 3 months after distraction (T2). All the measurements were describled by means of median, minimum and maximum. In order to evaluate differences between each time interval, a Wilcoxon test associated to a Delta Cliff test was used to evaluate the effect size (level of significance adopted was 5%). A significant maxillary advancement and increased upper airway antero-posterior dimensions were observed after the distraction osteogeness process, as demonstrated by the difference between T1 and T0. No significant relapse at T2 was found. Lower airway and the airway at tip of uvula region did not display significant alterations. A significant maxillary advancement and increased antero-posterior upper airway dimension was measured immediately after maxillary distraction with rigid external distraction in non growing cleft patients. The findings were stable three years after distraction.
牵引成骨术（DO）是矫正严重上颌发育不全的一种非常有效的技术，尤其适用于唇腭裂和颅面综合征患者。本回顾性纵向研究的目的是评估非生长性腭裂患者使用刚性外牵引系统（RED）行上颌骨前徙术后长期气道改变。本研究纳入了 15 名年龄在 14 至 25 岁的腭裂患者（8 名男性和 7 名女性）。所有患者均接受了经高位 Le Fort I 截骨术的刚性外牵引系统治疗以实现上颌骨前徙。为了分析气道变化，在牵引前（T0）、牵引即刻（T1）以及牵引后 1 至 3 年 3 个月（T2）时获得侧位头颅侧位片。所有测量值均采用中位数、最小值和最大值进行描述。为了评估各时间间隔之间的差异，使用 Wilcoxon 检验结合 Delta Cliff 检验评估效应大小（采用的显著性水平为 5%）。牵引成骨过程后观察到上颌明显前徙和上气道前后径增加，T1 与 T0 之间的差异表明了这一点。在 T2 时未发现明显复发。下气道和悬雍垂尖端的气道没有显示出明显的变化。在非生长性腭裂患者中，使用刚性外牵引进行上颌骨牵引后立即测量到明显的上颌前徙和上气道前后径增加。牵引后 3 年，结果稳定。
