Abstract:
:Patients with severe maxillary hypoplasia secondary to congenital facial clefting present numerous challenging problems for the reconstructive surgeon. Traditional surgical/orthodontic approaches for these patients often fall short of expectations, especially for achieving normal facial aesthetics and proportions. The purpose of this paper is to present our clinical experience and cephalometric results with the use of rigid external distraction for the treatment of patients with severe maxillary deficiency. Eighteen consecutive orofacial cleft patients with severe maxillary hypoplasia were treated with maxillary distraction osteogenesis. Criteria for patient selection included severe maxillary hypoplasia with negative overjet of 8 mm or greater, patients with normal mandibular morphology, and patients with full primary dentition or older. There were 10 unilateral cleft lip and palate patients, 6 bilateral cleft lip and palate patients, and 2 patients with severe congenital facial clefting. A maxillary splint was prepared for each patient, and all patients underwent a high Le Fort I maxillary osteotomy. All surgery was performed on either an outpatient or a 23-hour admission basis. No patient required blood transfusions or intermaxillary fixation. Two types of mechanical distraction were utilized in this series. In group 1 (n = 14), the patients underwent rigid external distraction with an external distraction device. In group 2 (n = 4), patients underwent face mask distraction with elastics. There was no surgical morbidity in any of the patients. For the patients in the rigid external distraction group, the mean effective horizontal advancement of the maxilla was 11.7 mm. All of these patients had correction of their negative overjet. For patients in the face mask distraction group, the results were disappointing. The mean effective advancement of the maxilla in this group was only 5.2 mm. In all face mask distraction patients, the initial maxillary hypoplasia was undercorrected. Maxillary distraction osteogenesis with rigid external distraction permits full correction of the midfacial deficiency, including both the skeletal and soft-tissue deficiencies. Rigid external distraction in patients with severe maxillary hypoplasia allows full correction of the deformity through treatment of the affected region only. It offers the distinct advantage of correcting these severe deformities through a minimal procedure. Rigid external distraction has dramatically improved our treatment results for patients with severe cleft maxillary hypoplasia.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Polley JW,Figueroa AAsubject
Has Abstractpub_date
1998-10-01 00:00:00pages
1360-72; discussion 1373-4issue
5eissn
0032-1052issn
1529-4242journal_volume
102pub_type
杂志文章abstract::In short, our device allows a surgeon who is harvesting adipose tissue for autologous fat transplantation to immediately, easily, efficiently, and sterilely isolate adipose tissue from the unwanted waste components that are associated with primary liposuction effluent. It does so by "trapping" the fat tissue contained...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200102000-00047
更新日期:2001-02-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197811000-00006
更新日期:1978-11-01 00:00:00
abstract::Von Willebrand's disease, a common hereditary bleeding disorder, may be responsible for undue or unanticipated intraoperative or postoperative hemorrhage. The diagnosis may be difficult to establish, although it may be suspected clinically and can usually be confirmed by adequate laboratory investigation. Patients wit...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197609000-00018
更新日期:1976-09-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:The ptotic breast is surgically rejuvenated through a mastopexy procedure. Recurrent ptosis or other negative changes to the breast shape are not uncommon following mastopexy, as the tissue laxity and skin quality that contributed to ptosis are not surgically corrected. The purpose of this study was to asses...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-06-01 00:00:00
abstract::To reconstruct intraoral lining defects after radical tumor resection by reinnervated vascularized mucosa, eight distal radial forearm flaps and two fibula flaps were prelaminated. Prelamination was performed by exposing the vascularized fascia, onto which the split distal end of a sural graft was fixed. The fascia an...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199903000-00007
更新日期:1999-03-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000179
更新日期:2014-06-01 00:00:00
abstract::A large animal model to assess fetal fracture repair and the ability to close excisional bony defects is presented. Incisional and excisional ulnar fractures were made in 14 midgestation fetal lambs, harvested at serial time points, and subjected to high-resolution low-kilovolt magnification radiographs, magnetic reso...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1992-08-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200002000-00011
更新日期:2000-02-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197602000-00029
更新日期:1976-02-01 00:00:00
abstract::This study describes the treatment protocol for and the outcome of the management of complex wounds around total knee replacements. An analysis of 28 patients (29 knees) with complex defects who had surgery between January 1, 1986, and July 30, 1996, was performed. A specific management protocol was applied to each kn...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199911000-00012
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Recent studies have demonstrated low levels of National Institutes of Health funding for surgical research. The authors compared the funding in plastic surgery with the funding for other surgical specialties. METHODS:A query of National Institutes of Health grants awarded to departments of surgical specialt...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003866
更新日期:2017-12-01 00:00:00
abstract::Breast cancer is the tumor with the highest prevalence and incidence in women. Reduction mammaplasty is one of the most common procedures performed in Brazil by the plastic surgeon, and it is not uncommon for the surgeon to find a breast tumor during the operation or afterward, when the histopathological report is rec...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000152683.62899.50
更新日期:2005-03-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199202000-00017
更新日期:1992-02-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197812000-00013
更新日期:1978-12-01 00:00:00
abstract:BACKGROUND:Composite defects of the oral cavity are often the result of trauma or advanced-stage tumor extirpation. The resultant deformity frequently requires a three-dimensional reconstruction of bone and soft-tissue. The fibula free flap is the preferred method of reconstruction, with various modifications focused o...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000216
更新日期:2014-06-01 00:00:00
abstract::The distally based radial artery forearm flap has become our workhorse flap for hand and finger coverage, relying on reversed or retrograde venous outflow through the venae comitantes. Free-flap transfer, however, has been used by us only with antegrade venous anastomoses. This study was intended to determine if a sin...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199202000-00006
更新日期:1992-02-01 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Discuss the critical anatomic structures of the nose that are affected in naso-orbital ethmoid fractures. 2. Discuss the advantages of early, complete nasal reconstruction of these fractures. 3. Apply a clinical algorithm to such nas...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000195081.39771.57
更新日期:2006-01-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000200615.77678.f1
更新日期:2006-03-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198008000-00014
更新日期:1980-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2006-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/PRS.0000000000005865
更新日期:2019-08-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:1994-02-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2009-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2017-11-01 00:00:00
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更新日期:2020-08-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:1993-07-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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更新日期:2008-07-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199808000-00009
更新日期:1998-08-01 00:00:00