No evidence for long-term effectiveness of early osteodistraction in hemifacial microsomia.
BACKGROUND
The authors performed a critical literature review to find evidence of the long-term stability after early distraction osteogenesis of the mandible in patients with hemifacial microsomia.


METHODS
The PubMed, Cochrane, MEDLINE, EMBASE, CENTRAL, and CINAHL databases were searched systematically for studies performed between 2002 and 2008. Abstracts from the 89 relevant articles were reviewed for evidence.


RESULTS
Thirteen articles met the inclusion criteria. Data were tabulated with respect to the length of follow-up, number of patients, age group, Pruzansky-Kaban classification of the patients, methods of analysis and validation, and level of evidence. Methods for long-term follow-up studies were not standardized, and no objective studies have been published on stability after growth cessation.


CONCLUSIONS
Thus far, no randomized controlled trials on early distraction osteogenesis in hemifacial microsomia patients have been published. The authors conclude that there is a lack of statistical evidence to support the use of early distraction osteogenesis for correcting hemifacial microsomia as a single treatment modality. The results call into question its rationale.
Nagy
Krisztián
K
Bruges, Belgium; and Nijmegen, The Netherlands From the Bruges Cleft and Craniofacial Center, General Hospital St. Jan, and the Department of Orthodontics and Oral Biology and the Cleft Palate Craniofacial Center, Radboud University Nijmegen Medical Center.
Kuijpers-Jagtman
Anne Marie
AM
Mommaerts
Maurice Y
MY
D002675:Child, Preschool; D005146:Facial Asymmetry / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery*; D005147:Facial Bones / Q000002:abnormalities / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008334:Mandible / Q000002:abnormalities / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome