title: Maxillary distraction resulting in facial advancement at Le Fort III level in cleft lip and palate patients: a report of two cases.
abstract: An 18-year-old female and a 14-year-old male who had previously received surgery for primary repair of a nonsyndromic cleft lip and palate (including alveolar defect bone grafting) unintentionally developed facial advancement at the Le Fort III level after surgical correction of their maxillary hypoplasia. The Le Fort I osteotomy, originally performed for their maxillary dentoalveolar hypoplasia, was an incomplete osteotomy. It was performed without down-fracture, leaving the pterygomaxillary and septal junctions intact. The gradual advancement of the maxilla during distraction osteogenesis was planned to correct the hypoplastic maxilla, and also prevent subsequent hypernasality; however, during the distraction procedure by means of a rigid external device both patients developed an unintentional facial advancement at the Le Fort III level.
authors.affiliation: Department of Maxillo-Facial and Oral Surgery, Oral and Dental Hospital, Pretoria, South Africa. zwahlen.onofri@tiscali.ch
authors.forename: Roger A
authors.initials: RA
authors.lastname: Zwahlen
authors.forename: Kurt-W
authors.initials: KW
authors.lastname: Bütow
mesh_terms: D000293:Adolescent; D016025:Bone Transplantation; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D015841:Enophthalmos / Q000209:etiology; D005147:Facial Bones / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005624:Frontal Bone / Q000473:pathology; D006801:Humans; D008297:Male; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery*; D009295:Nasal Bone / Q000473:pathology; D009300:Nasal Septum / Q000473:pathology; D019857:Osteogenesis, Distraction / Q000009:adverse effects* / Q000379:methods; D019340:Osteotomy, Le Fort / Q000145:classification / Q000379:methods; D013100:Sphenoid Bone / Q000473:pathology; D015050:Zygoma / Q000473:pathology