Adequate surgical correction requires an individually staged strategy with respect to severity of the deformity, age and development of the patient. Frontofacial distraction techniques have been recommended for that purpose.

The surgical strategy for the simultaneous correction might consist in fronto-orbital remodelling by a floating technique according to Marchac and Renier in combination with the advancement of the zygomatico-maxillary complex after LeFort-III disimpaction by one pair of internal distraction devices with an anterocaudal vector of distraction. We present our experiences with this technical modification of the fronto-facial advancement in three syndromic patients between 2.5 and 13 years.

Despite different complications obvious skeletal and functional improvements were achieved in all three patients. Correct positioning in an anterocaudal direction near to the centre of resistance of the facial mass as well as adequate stability of the devices during active distraction and consolidation phase were crucial for a successful procedure. Both were provided by individually selected internal distraction devices.

Simultaneous management of midfacial retrusion and anterior cranial vault deformity in children affected by CFD is possible by combining anterior cranial vault remodelling and LeFort-III-advancement driven by one pair of internal distraction devices.

Conflict of interest: None declared.