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doi: 10.1597/06-104
The Cleft Palate-Craniofacial Journal: Vol. 44, No. 3, pp. 274–277.

Long-term Follow-up After Maxillary Distraction Osteogenesis in Growing Children With Cleft Lip and Palate

Chiung-Shing Huang, D.D.S., Ph.D.
Pandurangan Harikrishnan, B.D.S., M.D.S., F.D.S.R.C.S. (Eng.)
Yu-Fang Liao, D.D.S., Ph.D.
Ellen W.C. Ko, D.D.S., M.S.
Eric J.W. Liou, D.D.S., M.S.
Philip K.T. Chen, M.D.

Drs. Huang, Liao, Ko, Liou, and Chen are affiliated with the Craniofacial Center, Chang Gung Memorial Hospital, Taipei, Taiwan, and College of Medicine, Chang Gung University, Taoyuan, Taiwan. Dr. Harikrishnan was a clinical fellow with the Craniofacial Center, Chang Gung Memorial Hospital, Taipei, Taiwan

Submitted June 2006; Accepted September 2006.

Objective: To evaluate the changes in maxillary position after maxillary distraction osteogenesis in six growing children with cleft lip and palate.

Design: Retrospective, longitudinal study on maxillary changes at A point, anterior nasal spine, posterior nasal spine, central incisor, and first molar.

Setting: The University Hospital Craniofacial Center.

Main Outcome Measure: Cephalometric radiographs were used to measure the maxillary position immediately after distraction, at 6 months, and more than 1 year after distraction.

Results: After maxillary distraction with a rigid external distraction device, the maxilla (A point) on average moved forward 9.7 mm and downward 3.5 mm immediately after distraction, moved backward 0.9 mm and upward 2.0 mm after 6 months postoperatively, and then moved further backward 2.3 mm and downward 6.8 mm after more than 1 year from the predistraction position.

Conclusion: In most cases, maxilla moved forward at distraction and started to move backward until 1 year after distraction, but remained forward, as compared with predistraction position. Maxilla also moved downward during distraction and upward in 6 months, but started descending in 1 year. There also was no further forward growth of the maxilla after distraction in growing children with clefts.

KEY WORDS:cephalometry, cleft lip and palate, distraction osteogenesis, growth, maxilla


© 2007, The American Cleft Palate-Craniofacial Association