title: [Rational use of distraction osteogenesis in craniofacial surgery].
abstract: Distraction osteogenesis, initially developed by Ilizarov for limb, is the tissular extension caused by the progressive space of the osseous pieces following an osteotomy. Distraction is osteogenesic and histogenic. Twenty-five years ago, at the instigation of McCarthy, this technique was used to handle the craniofacial malformations in the various floors of the face : mandibular, mediofacial and cranial. The most wide-spread protocols respect a latency period from 0 to 7 days, a rhythm of distraction from 1 to 2mm a day in 2 at 4 times and a period of consolidation from 4 to 8 weeks. Distraction is the result of the inventiveness of the pioneers then the work to always adapt to the multiple complex clinical situations. The surgeon has to choose between internal or external materials allowing a mono- or multi-vectorial extension, in osseous and/or dental anchoring. The mandibular distraction is very effective for the treatment of the secondary obstructive syndromes in the unilateral or bilateral severe hypomandibular malformations. She also allows desobstruction of the superior airways within the framework of the mediofacial hypoplasies as well as the secondary treatment of the growth defects in cleft lips and palates. Finally, the distraction osteogenesis enhanced reliability of the fronto-facial advancement in early and secondary treatment of craniofaciosynostosis. This is a real support of the facial growth, which has to be included in a plan of global treatment.
authors.affiliation: Service de chirurgie plastique reconstructrice et esthétique, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, Lille, France; Centre de référence des malformations crânio-faciales rares, CRMCFR, Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Guerreschi
authors.affiliation: Service de chirurgie plastique reconstructrice et esthétique, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, Lille, France; Centre de référence des malformations crânio-faciales rares, CRMCFR, Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Wolber
authors.affiliation: Service de chirurgie plastique reconstructrice et esthétique, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, Lille, France. Electronic address: yasbennis0311@gmail.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Bennis
authors.affiliation: Centre de référence des malformations crânio-faciales rares, CRMCFR, Lille, France; Service de neurochirurgie pédiatrique, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, Lille, France.
authors.forename: M
authors.initials: M
authors.lastname: Vinchon
authors.affiliation: Service de chirurgie plastique reconstructrice et esthétique, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, Lille, France; Centre de référence des malformations crânio-faciales rares, CRMCFR, Lille, France.
authors.forename: V
authors.initials: V
authors.lastname: Martinot-Duquennoy
mesh_terms: D019465:Craniofacial Abnormalities / Q000601:surgery*; D006801:Humans; D019857:Osteogenesis, Distraction / Q000295:instrumentation
keywords: Chirurgie craniofaciale; Cranial; Craniofacial surgery; Craniomaxillofacial skeleton; Crânien; Distraction osseuse; Distraction osteogenesis; Mandible; Mandibule; Maxilla; Maxillaire supérieur; Squelette cranio-maxillo-facial