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Journal of Korean Cleft Palate-Craniofacial Association 2000;1(1):67-72.
Treatment of Hemifacial Microsomia Patients Using Two Pin System External Distraction Device.
Dae Hyun Lew, Chul Park, Beyoung Yun Park
Department of Plastic & Reconstructive Surgery, College of Medicine, Yeonsei University, Seoul, Korea. dhlew@yumc.yonsei.ac.kr
Ever since the introduction of human mandible distraction in hemifacial microsomia by McCarthy in 1992, it has developed into a common reliable procedure. But unfavorable results can occur from ineffective growth of a segment due to inadequate vector control, distraction failure from poor osteotomy or premature consolidation from inadequate distraction rate. There are too many kind of distraction devices including external and internal application. External devices are more easy to apply and can get better result than internal devices but it was inconvenient for patients and remaining many scar. Among the external devices, the Molina semirigid two pin system device has several advantages such as easy to apply and less scar. We used this two pin system external device for correct hemifacial microsomia patients. The osteotomy was performed in complete bicortical subtotal manner and the fracture was confirmed by activation of device during the operative procedure. we treated 25 cases of hemifacialmicrosmia patents during last 2 years, There are some complication such as pin site infection or pin loosening, lateral cross bite, prognathsm due to malaligned distraction vector, delayed consolidation, distraction failure or device failure, tooth bud injury. But exact diagnosis, planning and operation can prevent such complication and can correct not only occlusal canting but also he midline shifting with satisfaction. For the successful distraction osteogenesis, proper osteotomy and vector control were most important. And for the prevention of relapse, post operative orthodontic treatment was essential and thus achieving satisfactory aesthetic and functional results.
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