Distraction osteogenesis of the mid-face alleviates the requirements of substantial autogenous bone grafts and donor site morbidity and alleviates the restriction of the soft-tissue envelope in gaining advancement of the mid-face. Conventional surgical management of severe midfacial retrusion in the patient with syndromic craniosynostosis has many limitations. These limitations include the requirement for substantial autologous bone grafts with consequent donor site morbidity and difficulty obtaining the desired amount of advancement in these patients due to the restriction of the soft-tissue envelope. Distraction osteogenesis alleviates these problems and is an alternative for mid-facial advancement. A prospective study, over a 14-month period, was initiated to evaluate the results of seven consecutive patients undergoing mid-facial advancement who were treated with Le Fort III internal distraction. We treated midface hypoplasia in a 28-year-old woman with Crouzon syndrome using a rigid internal distraction device. The patient showed severe exophthalmos and maxillary retrusion, although relatively good occlusion had been achieved by long-term orthodontic procedures. The patient’s occlusion was fully corrected, and her facial contour was significantly improved. Our modified technique was helpful in increasing the usefulness of the internal distraction system and in refining the midface distraction procedure. It was concluded The modular internal distraction system permits widespread application of easily customizable, buried distraction devices throughout the craniofacial region and offered as a substitute for the traditional Le Fort III advancement and bone grafting.

Key words : Crouzon; internal distraction; syndromes