牵张成骨术治疗腭裂术后严重上颌骨后缩畸形

目的：观察应用牵张成骨技术治疗腭裂术后继发的严重上颌骨后缩畸形的效果。方法：对10例腭裂术后继发严重上颌骨后缩畸形的患者，术前常规行头影测量和模型外科设计；手术采用上颌骨Le Fort Ⅰ型截骨术，4例使用颅骨支抗外置式牵张器，其余患者采用内置式牵张器进行骨牵张术；术后延迟期为7d，牵张节律为0．8—1mm／d，2—4次／d，牵张结束后固定8-12周。结果：术后伤口一期愈合，牵张过程顺利，最大牵张距离为22mm，最小距离为15mm；患者的面形得到明显改善，未出现畸形愈合或骨不连接等并发症。结论：牵张成骨技术应用于腭裂术后继发的严重上颌骨后缩畸形，不需要植骨，可有效地达到上颌骨前徙、明显改善面形的目的。

Distraction osteogenesis in correction of severe retro-maxillary deformity after cleft palate repair

Objective: To investigate the distraction osteogenesis technique in correction of severe retro-maxillary deformity following the repair of cleft palate. Methods:10 patients were included in the study. Orthodontic treatment was used as a regular procedure before operation. Distraction osteogenesis technique was used to correct the deformity and malocclusion. 4 of patients applied with the external distractor and others with internal distractor. Latency period was 7 days. Distraction rhythm is 0.8~1 mm/d,2~4 times/d. Consolidation period was 8~12 weeks. Orthognathic surgery was done after distraction finished when necessary. Results:The treatment process was smooth and no severe complication occurred. The maximum of distraction distance is 22 mm, and the minimum of distraction distance was 15 mm. No malunion or ununion occurred in all 10 patients. All the patients were satisfied with the results. Conclusion:Distraction osteogenesis is more suitable for correction of severe retro-maxillary deformity following the repair of cleft palate. Bone transplantation is unnecessary during the operation process with easier handling and lower risk.