[Surgical correction of severe maxillary hypoplasia secondary to the repairment of congenital cleft palate].

[OBJECTIVE] To evaluate the surgical corrective results of severe maxillary hypoplasia in cleft lip and palate patients using distraction osteogenesis (DO) and orthognathic surgical procedures.

[METHODS] High step Le Fort I osteotomy was performed in 17 cases. Le Fort I segments were moved forward with DO (11 cases with internal distraction device, 6 cases with rigid external distraction device). Maxillary anterior segmental osteotomy was performed in another 6 cases, the maxillary anterior segments were advanced with DO (3 cases with internal distraction device, 3 cases with rigid external distraction device). Bilateral sagittal split ramus osteotomy and genioplasty were performed in 13 cases. Before surgery, when DO was completed and 12 months after DO was completed, oriented lateral cephalograms at rest position of each patient were taken, the position of point A on horizontal direction and SNA angle were collected and analyzed.

[RESULTS] All patients had successfully accomplished maxillary segment DO. Point A had been moved forward 7.9 mm on average in horizontal direction when DO was completed, and maintained 7.1 mm when DO was completed 12 months. The average of SNA angle was 70.8 degree pre-surgery, but 81.6 degree when DO was completed, and maintained 80.9 degree at 12 months after DO was completed.

[CONCLUSION] The severe maxillary hypoplasia in cleft lip and palate patients can be successfully corrected with DO and orthognathic surgical procedures. The long-term skeletal stability was satisfactory.