Surgical management with osteogenic distraction for midface hypoplasia in a specialized institute in Lima, Peru

• Autores: Oré Acevedo, Juan Francisco, Urteaga Quiroga, Rosmery, Castillo Chávez, Katerin Carmen
• Formato: artículo
• Fecha de Publicación: 2025
• Institución: Instituto Nacional de Salud del Niño San Borja
• Repositorio: INSNS - Revistas
• Lenguaje: español
• OAI Identifier: oai:ojs.pkp.sfu.ca:article/121
• Enlace del recurso: https://investigacionpediatrica.insnsb.gob.pe/index.php/iicqp/article/view/121
• Nivel de acceso: acceso abierto
• Materia: Osteogénesis por Distracción; Maxilar; Síndrome de Apert; Enfermedad de Crouzon; Exoftalmía

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.