抄録
Treatment for cases with midface hypoplasia such as Apert syndrome and Crouzon syndrome should aim to achieve well-harmonized occlusion and maxillofacial morphology. To date, orthodontic treatments using Le Fort Ⅲ osteotomy concomitant with Le Fort Ⅰ or Ⅱ osteotomy have been reported. In this paper, we present a case with Apert syndrome treated by Le Fort Ⅲ distraction osteogenesis （LFⅢDO） followed by open rhinoplasty with iliac bone grafting and Le Fort Ⅰ osteotomy.
The patient was a 16-year-old girl with Apert syndrome. She was characterized by severe midface hypoplasia representing skeletal Class Ⅲ occlusion with open bite. After the completion of preoperative orthodontic treatment, 12mm of midface advancement was performed by LF Ⅲ DO by using an internal distraction device. After the DO, although anterior open bite was slightly worse, midface hypoplasia and proptosis were significantly improved. Open rhinoplasty with iliac bone grafting was carried out 2 months after the LF Ⅲ DO. 5 months after the rhinoplasty, Le Fort Ⅰ osteotomy was performed to correct the anterior open bite.
As a result, well-harmonized occlusion and maxillofacial morphology were achieved by close cooperation between the orthodontist, oral and maxillofacial surgeons and plastic surgeons.
