title: Simultaneous hybrid of maxillary Le Fort I halo distraction and mandibular set-back for patients with severe cleft jaw deformity.
abstract: One of the surgical tactics and retrospective chart review of clinical cases are described for severe maxillo-mandibular discrepancy. The recently developed Le Fort I Halo distraction combined with mandibular sagittal splitting osteotomy is initially carried out simultaneously. Materials include six adult patients revealing severe jaw deformity with mandibular prognathism somehow ranging from 17-19 years of age. The required adjustment of the maxillo-mandibular discrepancy ranged from 14-23 mm to obtain the preferred occlusion. The simultaneous combination of over 10-mm maxillary Le Fort I Halo distraction with mandibular set-back secured rigidly by sagittal splitting was accomplished. The amount of mandibular set-back ranged from 4-6 mm. The amount of maxillary Le Fort I halo distraction ranged from 10-17 mm (Table I). The retention period of the halo brace was 21-22 days. In addition, the Delair type of face mask was used for 3-4 months as a night splint for consolidation after removal of the halo brace. Satisfactory maxillary distraction and mandibular set-back as planned preoperatively was obtained in all six cases. No particular postoperative complications were noticed. Compared with standard Le Fort I advancement for cleft patients, more advancement can be obtained easily with halo distration, particularly in cases where a large amount of advancement > 10 mm is required. This combination is worthwhile for a severe cleft jaw deformity, and is an alternative for standard double jaw osteotomy.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Showa University, School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan. kane.satoh@med.showa-u.ac.jp
authors.forename: Kaneshige
authors.initials: K
authors.lastname: Satoh
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Mitsukawa
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Tosa
authors.forename: Kohichi
authors.initials: K
authors.lastname: Kadamatsu
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hosaka
mesh_terms: D000293:Adolescent; D000328:Adult; D002508:Cephalometry; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000295:instrumentation* / Q000379:methods; D019340:Osteotomy, Le Fort / Q000379:methods*