Maxillary anterior segmental distraction osteogenesis with the dynaform system for severe maxillary retrusion in cleft lip and palate.

摘要

Midfacial retrusion and velopharyngeal in-competence are the two major chal-llenges in the treatment of cleft lip-cleft palate. Any simultaneous maxillary advancement procedure that includes Le Fort osteotomy, which is considered to be the most common and the safest procedure for correction of maxillary retrusion, may result in velopharyngeal incompetence or deterioration of hypernasality. There have been a number of reports recently that describe the advantages of distraction osteogenesis in combination with Le Fort osteotomy for cleft palate patients, with which the patient's maxilla can be advanced with soft tissue in the distraction segment being regenerated. Some reports also suggest that the incidence of velopharyngeal incompetence is low with the above-mentioned procedure except for cases that require excessive advancement. It is clear, however, that this procedure may sometimes induce a morphologic change in the pharynx.