title: Advances in the Treatment of Syndromic Midface Hypoplasia Using Monobloc and Facial Bipartition Distraction Osteogenesis.
abstract: Midface hypoplasia or retrusion remains a persistent feature of syndromic craniosynostosis years after successful treatment of the cranium. Although expansion of the cranial vault in infancy by traditional fronto-orbital advancement, posterior expansion, or both, can treat the immediate intracranial constriction, midface hypoplasia and its stigmata of exorbitism, sleep apnea, central face concavity, and malocclusion remain suboptimally treated. Initial enthusiasm for the procedures was tempered due to a high rate of infectious complications; timing and indications for surgery continue to stir controversy. During the last decade renewed interest with the monobloc and facial bipartition procedure using distraction osteogenesis with either an internal or external distraction system has decreased morbidity significantly. These procedures have re-emerged as powerful and comprehensive tools in the treatment of syndromic midface hypoplasia.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Anand R
authors.initials: AR
authors.lastname: Kumar
authors.affiliation: Division of Plastic and Reconstructive Surgery, Yale University Hospital, New Haven, Connecticut.
authors.forename: Derek
authors.initials: D
authors.lastname: Steinbacher
keywords: distraction osteogenesis; facial bipartition; frontofacial advancement; midface hypoplasia; monobloc; syndromic craniosynostosis