Two plane distraction osteogenesis for midface and occlusal advancement in a patient with crouzon’s syndrome in a developing country

Introduction: A 22 year old female with Crouzon’s syndrome and sleep apnea was brought in by her family to the hospital Loayza in Lima Peru for treatment of her mid-face and maxillary hypoplasia. The patient had been seen by doctors before, but was unable to receive treatment because of a lack of technology and funding.

Objective: Due to the large amount of midface advancement needed, approximately 15 mm, and maxillary advancement of 10 mm, it was determined that she would be best treated by a 2 plane-distraction osteogenesis at the lefort 3 and lefort 1 level.

Case report: The Idaho Condor humanitarian services is a multidisplinary team that travels to Peru every year to educate and treat underserved communities. Several doctors coordinated together for this case. A Lefort 3 osteotomy was performed through various approaches and a lefort 1 osteotomy was also done using an intraoral vestibular incision. The distractor used was the RED external Distractor (KLS Martin). Instructions were given to the orthodontist and the patient on the phases of distraction and the importance of compliance.

Results: The patient received midface advancement of more than 15 mm and maxillary advancement of 10 mm with the Red external distractor. Her sleep apnea is improving and she pleased with her changes after surgery.

Conclusion: Syndromic patients in underserved communities are a difficult set of patients to treat and manage. A 2 plane Lefort 3/Lefort 1 distraction osteogenesis is a good technique to correct maxillofacial deficiencies in syndromic patients.

Conflict of interest: None declared.

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Feb 5, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Two plane distraction osteogenesis for midface and occlusal advancement in a patient with crouzon’s syndrome in a developing country
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