Philadelphia, Pa. (March 14, 2014) - A technique called distraction osteogenesis can create increased length of the upper jaw in patients with cleft lip and palate deformities, reports a study in the March issue of The Journal of Craniofacial Surgery, edited by Mutaz B. Habal, MD, published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
Distraction Technique Used to Lengthen the Palate
Dr. Emeka Nkenke of Erlangen University Hospital, Germany, and colleagues, report on the use of distraction osteogenesis to lengthen the maxilla (upper jaw) bone in patients with cleft lip and palate. In this technique, hardware is placed to gradually "stretch" bone in the desired direction. The researchers studied the bone-lengthening approach because the maxilla often regresses toward its original position after standard surgical advancement techniques.
Distraction osteogenesis was used in seven adolescent to young adult patients with cleft lip and palate deformities and "maxillary hypoplasia" (very small maxilla). The technique successfully increased the length of the maxilla by an average of 6.4 millimeters. During follow-up, the new bone regressed significantly--by about 7.5 percent. However, that was much less than the 50 percent or greater regression that can occur after standard surgical approaches.
Complications included an infection in one patient and loosening of the distraction hardware in another. Dr. Nkenke and coauthors conclude that, when needed to create maxillary bone length of no more than 12 millimeters, the benefits of the distraction osteogenesis technique outweigh the risks.
Another paper in the March issue includes a report of a very unusual complication from a sports-related injury.
Three Months after Soccer Injury, an Unusual Complication
Dr. Nebil Yeşiloğlu and colleagues of Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, report the unusual case of a man with an infected, draining wound on his chin. Three months earlier, he had been kicked in the jaw during a soccer game. He had a small cut at the time, which healed over.
X-rays and CT scans showed a vague abnormality of the jaw bone, but couldn't identify the cause of the wound. On operating, the surgeons were surprised to discover a two-centimeter plastic cleat from a soccer shoe, embedded close to the bone.
After the cleat was removed and the area was cleaned, the wound healed without further problems. The authors highlight the need to carefully assess the patient's history for clues as to possible unusual foreign bodies that may not appear on x-rays.
About The Journal of Craniofacial Surgery
The Journal of Craniofacial Surgery, which will be celebrating 25 years of publication in 2014, serves as a forum of communication for all those involved in craniofacial and maxillofacial surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. The Journal shares a global partnership with affiliates around the world, including the American Association of Pediatric Plastic Surgeons, the American Academy of Pediatrics Section of Pediatric Plastic Surgery, the American Society of Craniofacial Surgeons, the American Society of Maxillofacial Surgeons, the Argentine Society of Plastic Surgery Section of Pediatric Plastic Surgery, the Asian Pacific Craniofacial Association, the Association of Military Plastic Surgeons of the U.S., the Brazilian Society of Craniofacial Surgeons, the European Society of Craniofacial Surgery, the International Society of Craniofacial Surgery, the Japanese Society of Craniofacial Surgery, the Korean Society of Craniofacial Surgery, the Thai Cleft and Craniofacial Association, and the World Craniofacial Foundation.
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