Long-Term Outcomes After External Maxillary Distraction Surgery in Patients With Down Syndrome : Journal of Craniofacial Surgery

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Clinical Studies

Long-Term Outcomes After External Maxillary Distraction Surgery in Patients With Down Syndrome

Arnold, Sydney H. MD; Figueroa, Alvaro A. DDS, MS; Wiegmann, Aaron L. MD, MS; Lee, Jugyeong BS; Padala, Soumya BDS, MDS, MS; Hamati, Fadi BA; Hansdorfer, Marek A. MD; Tragos, Christina MD

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The Journal of Craniofacial Surgery 34(3):p 1045-1053, May 2023. | DOI: 10.1097/SCS.0000000000009203



Patients with Down syndrome have severe facial deformities that can precipitate functional consequences and social stigmatization. Craniofacial surgical intervention can play a role in improving these symptoms and patient quality of life. The objective of this study was to investigate the long-term outcomes of distraction osteogenesis and orthognathic surgical intervention in patients with Down syndrome.

Materials and Methods: 

Charts of 3 patients with Down syndrome who were treated with external maxillary distraction osteogenesis were retrospectively reviewed. The patients’ caregivers were prospectively interviewed between 10 and 15 years after surgery to determine surgical stability, long-term function, and quality of life status.


All patients and their caregivers reported excellent results with improvements in function and quality of life. Facial skeletal changes have been stable over time. The cephalometric analysis demonstrated significant maxillary advancement in all 3 patients and mandibular changes to correct mandibular prognathism and asymmetry in the patient who underwent finishing orthognathic surgery.


External maxillary distraction osteogenesis and orthognathic surgery may be considered in select patients with Down syndrome as part of their multidisciplinary health care. These interventions can result in long-term improvements in patient function and quality of life.

Copyright © 2023 by Mutaz B. Habal, MD

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