Mandibular Distraction in Unilateral Craniofacial Microsomia: Longitudinal Results until the Completion of Growth

Abstract

Background: The purpose of this study was to evaluate the results of long-term follow-up in patients with relatively severe unilateral craniofacial microsomia after mandibular distraction.Methods: The sample consisted of 26 patients with an average age of 6.08 years at the time of distraction. All patients had nonsyndromic unilateral craniofacial microsomia (Pruzansky-Kaban types IIA, IIB, and III). Follow-up for all patients continued until the completion of growth. The 26 clinical records and posteroanterior cephalograms of the patients, taken before distraction (time 0) and approximately 1, 4, and 11 years (time 1, time 2, and time 3, respectively) after distraction, were used. Four items (i.e., supraorbital tilting angle and occlusal tilting angle to the horizontal reference line, and maxillary and mandibular tilting angles to the vertical reference line) were analyzed at each of the four time intervals.Results: The overall mean distraction amount was 23 mm vertically and 21 mm horizontally. The average cephalometric follow-up was 131.7 months. In this study, the mandibular horizontal and vertical changes after distraction showed a gradual return of the asymmetry with growth in all patients. There were no statistically significant differences in any of the analyzed angles between the preoperative and final records, except for the supraorbital tilting angle.Conclusions: The longitudinal results achieved by distraction osteogenesis were unstable and generally led to relapse, although they were very good in the early postoperative period. Therefore, further efforts are suggested to find a solution that prevents relapse.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.