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No Evidence for Long-Term Effectiveness of Early Osteodistraction in Hemifacial Microsomia ‘Outcomes Article’

Nagy, Krisztián, M.D., D.M.D.; Kuijpers-Jagtman, Anne Marie, D.M.D., Ph.D.; Mommaerts, Maurice Y., M.D., D.M.D., Ph.D.

Plastic and Reconstructive Surgery: December 2009 - Volume 124 - Issue 6 - p 2061-2071
doi: 10.1097/PRS.0b013e3181bcf2a4
PEDIATRIC/CRANIOFACIAL: ORIGINAL ARTICLES
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Background: The authors performed a critical literature review to find evidence of the long-term stability after early distraction osteogenesis of the mandible in patients with hemifacial microsomia.

Methods: The PubMed, Cochrane, MEDLINE, EMBASE, CENTRAL, and CINAHL databases were searched systematically for studies performed between 2002 and 2008. Abstracts from the 89 relevant articles were reviewed for evidence.

Results: Thirteen articles met the inclusion criteria. Data were tabulated with respect to the length of follow-up, number of patients, age group, Pruzansky-Kaban classification of the patients, methods of analysis and validation, and level of evidence. Methods for long-term follow-up studies were not standardized, and no objective studies have been published on stability after growth cessation.

Conclusions: Thus far, no randomized controlled trials on early distraction osteogenesis in hemifacial microsomia patients have been published. The authors conclude that there is a lack of statistical evidence to support the use of early distraction osteogenesis for correcting hemifacial microsomia as a single treatment modality. The results call into question its rationale.

Bruges, Belgium; and Nijmegen, The Netherlands

From the Bruges Cleft and Craniofacial Center, General Hospital St. Jan, and the Department of Orthodontics and Oral Biology and the Cleft Palate Craniofacial Center, Radboud University Nijmegen Medical Center.

Received for publication December 22, 2008; accepted June 17, 2009.

Disclosure:None of the authors has a financial interest to declare in relation to the content of this article.

Maurice Y. Mommaerts, M.D., D.M.D., Ph.D., Bruges Cleft and Craniofacial Center, AZ St. Jan av, Ruddershove 10, B-8000 Brugge, Belgium, craniofacial@azbrugge.be

©2009American Society of Plastic Surgeons