Distracción osteogénica del tercio medio facial en malformaciones cráneo maxilofaciales en un instituto especializado de Lima, Perú

Juan Francisco Oré Acevedo; Rosmery Urteaga Quiroga; Katerin Carmen Castillo Chávez

doi:10.59594/iicqp.2025.v3n1.121

Authors

Juan Francisco Oré Acevedo Instituto Nacional del Niño de San Borja, Lima, Perú https://orcid.org/0000-0002-5823-8316
Rosmery Urteaga Quiroga Instituto Nacional del Niño de San Borja, Lima, Perú https://orcid.org/0000-0001-5741-7331
Katerin Carmen Castillo Chávez Instituto Nacional del Niño de San Borja, Lima, Perú https://orcid.org/0000-0002-1991-5409

DOI:

https://doi.org/10.59594/iicqp.2025.v3n1.121

Keywords:

Osteogenesis Distraction, Maxilla, Apert Syndrome, Crouzon Disease, Exophthalmos

Abstract

Background: Several patients with Crouzon, Apert, or Pfeiffer syndrome, or those with cleft lip and palate, exhibit growth alterations of the craniofacial bones, including midface hypoplasia and exophthalmos that necessitate surgical correction, which is not routinely performed. Currently, bone distraction provides a reliable method for midface advancement through gradual traction of the bone segment.

Objective: To describe the outcomes of osteogenic distraction for the correction of midface hypoplasia in patients treated at a national children's hospital in Lima, Peru.

Methods: A review of medical records was conducted at the institution to identify patients who underwent midfacial distraction surgery between 2016 and 2022.

Results: We identified 22 patients who underwent bilateral midface osteogenic distraction, with a mean age of 15 years. The diagnoses were cleft lip and palate (72.7 %), Crouzon syndrome (22.7 %), and Apert syndrome (4.5 %). The most commonly performed procedure was modified quadrangular Le Fort II distraction in 9 cases (40.9 %). Following surgery, correction of exophthalmos, increased projection of the inferior orbital rim along with the malar and upper jaw, enlargement of the nasopharyngeal space, and advancement of the upper dentition due to bone advancement were observed.

Conclusion: The application of bone distraction is currently the gold standard technique to correct anteroposterior discrepancies greater than 10 mm of the midface, as it improves exophthalmos, the projection of the malar and upper jaw, increases the nasopharyngeal space, and achieves advancement of the upper arch.

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