2003 Volume 13 Issue 2 Pages 92-102
Although mandibular elongation by distraction osteogenesis is an effective procedure for treating hemifacial microsomia, improvement in the facial appearance and malocclusion is frequently difficult due to insufficient maxilla inferior elongation in cases of the distraction only in the mandible. Therefore, simultaneous distraction of the maxilla and mandible has been recently performed, in which distraction devices are placed only in the mandible, and the maxilla and mandible are simultaneously elongated, maintaining the occlusal relationship by intermaxillary fixation. However, there have been no reports of simultaneous maxillary and mandibular distraction osteogenesis, in which distraction devices were placed in both the maxilla and mandible, and bone elongation in the maxilla and mandible was separately performed. In this study, we performed simultaneous maxillary and mandibular distraction after inserting distraction devices in both the maxilla and mandible in a case of hemifacial microsomia.
The patient was a 14-year 4 month-old female, who was referred to our department because of facial asymmetry. The patient was diagnosed as having Murray's classification type II hemifacial microsomia with left hypoplasia in the mandibular ramus, coronoid process, and condylar process, and left hypoplasia of the maxillary bone, and underwent simultaneous maxillary and mandibular distraction 13 months after the preoperative orthodontic treatment.
In the maxilla, high Le Fort I osteotomy was performed, and an alveolar device was placed. In the mandible, corticotomy in the antegonial notch area was performed, and a mandibular distraction device was placed. As a result of simultaneous maxillomandibular bone extension, the left maxillary bone was vertically extended by approximately 10mm, and the mandibular bone was anteriorly extended by approximately 20mm, showing improvement in the occlusal plane inclination and facial asymmetry.
