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Le Fort II Midfacial Distraction Combined With Orthognathic Surgery in the Treatment of Nasomaxillary Hypoplasia

Yu, Hongbo DDS, MD; Dai, Jiewen DDS, PhD; Wang, Xudong DDS, MD; Zhang, Wenbin DDS, PhD; Shen, Steve Guofang DDS, MD

Journal of Craniofacial Surgery: May 2014 - Volume 25 - Issue 3 - p e241–e244
doi: 10.1097/SCS.0000000000000544
Brief Clinical Studies
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Patients with nasomaxillary hypoplasia have severe facial concavity and compromised skeletal class III malocclusion. Its treatment is still a challenge to surgeons. Our aim was to evaluate the combination of midfacial distraction and orthognathic surgery in the treatment of nasomaxillary hypoplasia. Four patients with nasomaxillary hypoplasia were enrolled in this study. After Le Fort II osteotomy, the rotational distraction of nasomaxillary complex was performed to rehabilitate facial convexity. Then bilateral sagittal split ramus osteotomy with or without Le Fort I osteotomy was used to correct malocclusion. All patients healed uneventfully, and the maxillae moved forward conspicuously. No obvious pain and severe discomfort were complained during distraction. A significant advancement and downward movement of the maxilla were shown by cephalometric analysis. The combination of midfacial distraction and orthognathic surgery provides us an ideal alternative in the treatment of nasomaxillary hypoplasia.

From the Department of Oral and Craniomaxillofacial Science, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Received October 3, 2013.

Accepted for publication November 13, 2013.

Address correspondence and reprint requests to Steve Guofang Shen, DDS, MD, Department of Oral & Craniomaxillofacial Science, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; E-mail: maxillofacsurg@163.com

H.Y. and J.D. contributed equally to this article.

This study was supported by grant (no. 81101131) from the National Natural Science Foundation of China.

The authors report no conflicts of interest.

© 2014 by Mutaz B. Habal, MD.