title: Respiratory outcome of midface advancement with distraction: a comparison between Le Fort III and frontofacial monobloc.
abstract: Upper airway stenosis in patients with faciocraniosynostosis is very common and often severe. Midface advancement, either with a Le Fort III or concomitantly to a monobloc frontofacial advancement, may prevent a tracheotomy or result in its ablation. The amelioration of respiratory function appears to be much better if the midface advancement is combined with distraction osteogenesis, although large studies with long-term follow-up are rare. In this study, we reviewed the respiratory outcome between Le Fort III with distraction and monobloc advancement with distraction in 54 faciocraniosynostotic patients. Early respiratory results of both procedures were very good and stable at long-term follow-up. The choice between a Le Fort III and a monobloc procedure is made on the basis of presenting morphology, previous surgery, and age. Both can be expected to give a long-lasting improvement of upper airway obstruction.
authors.affiliation: Department of Plastic Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Irene
authors.initials: I
authors.lastname: Mathijssen
authors.forename: Eric
authors.initials: E
authors.lastname: Arnaud
authors.forename: Daniel
authors.initials: D
authors.lastname: Marchac
authors.forename: Etienne
authors.initials: E
authors.lastname: Mireau
authors.forename: Marie-Paule
authors.initials: MP
authors.lastname: Morisseau-Durand
authors.forename: Philippe
authors.initials: P
authors.lastname: Guérin
authors.forename: Dominique
authors.initials: D
authors.lastname: Renier
mesh_terms: D000168:Acrocephalosyndactylia / Q000601:surgery; D000293:Adolescent; D000367:Age Factors; D000402:Airway Obstruction / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D003394:Craniofacial Dysostosis / Q000601:surgery; D003398:Craniosynostoses / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008437:Maxilla / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000145:classification / Q000379:methods*; D012086:Reoperation; D012119:Respiration; D012189:Retrospective Studies; D014139:Tracheostomy; D016896:Treatment Outcome