Evaluation of three surgical techniques for advancement of the midface in growing children with syndromic craniosynostosis

Pradip R. Shetye, Edward H. Davidson, Michael Sorkin, Barry H. Grayson, Joseph G. McCarthy

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


Background: The purpose of this study was to compare clinical outcomes and 1-year postsurgical stability with three different techniques of Le Fort III midface advancement. Methods: The records of 212 syndromic craniosynostosis patients were reviewed from the period 1973 to 2006. A total of 60 patients satisfied the inclusion criteria, and the mean age of the sample at surgery was 6.2 years. In group I (1977 to 1987), fixation was performed by interosseous wiring and intermaxillary fixation; in group II (1987 to 1996), fixation was achieved by only rigid plate fixation; and in group III (2000 to 2005), the patients underwent midface distraction with the rigid external distraction device. Cephalometric landmarks were identified and digitized at each of the time intervals (preoperatively, postoperatively, and 1 year postoperatively). Results: The mean advancement measured at point A in group I averaged 9.7 mm; in group II, it was 10.6 mm; and in group 3, it was 16.1 mm. There was no statistically significant difference in the amount of advancement between groups I and II. However, when groups I and II were compared with group III, there was a statistically significant difference (p < 0.05). No statistical significance was noted within and between all three groups at 1-year follow-up. Conclusions: Significantly larger midface advancement was achieved with rigid external distraction (group III) compared with classic Le Fort III midface advancement with wire (group I) or plate (group III) fixation. At 1 year after surgery, the three groups showed relative stability of the advanced midface segment.

Original languageEnglish (US)
Pages (from-to)982-994
Number of pages13
JournalPlastic and reconstructive surgery
Issue number3
StatePublished - Sep 2010
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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