Journal of Cleft Lip Palate and Craniofacial Anomalies

REVIEW ARTICLE
Year
: 2021  |  Volume : 8  |  Issue : 1  |  Page : 49--55

Comparison of conventional Le-fort I advancement, anterior maxillary segmental distraction, and distraction osteogenesis of maxilla for surgical management of cleft maxillary hypoplasia: A systematic review


Taher Abbas Mistry1, Abbas Mistry2 
1 Department of Maxillofacial Surgery, Saifee Hospital, Mumbai, Maharashtra, India
2 Department of Plastic and Reconstructive Surgery, Saifee Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Taher Abbas Mistry
Saifee Hospital, Mumbai, Maharashtra
India

This systematic review compares conventional Le-fort I advancement (CLO), anterior maxillary segmental distraction (AMD) and distraction osteogenesis of maxilla (DOM) for the treatment of cleft maxillary hypoplasia in terms of the amount of maxillary advancement achievable, relapse, residual velopharyngeal incompetence and soft tissue changes. All patients with maxillary hypoplasia secondary to cleft palate repair were taken into consideration irrespective of their gender, age and ethnic background. Literature research was done in databases PubMed, Ovid and Google scholar beta. From the original 429 articles identified, 17 articles were finally included, which passed the critical appraisal checklist and met the inclusion criteria. The mean advancement ranged from 6.59 mm to 16.5 mm for DOM, 6–14.28 mm for AMD and 5.17–7.2 mm for CLO. Relapse was 8.24%–45% for DOM, 4.6%–7% for AMD and 21.63%–63% for CLO. Velopharyngeal insufficiency increased significantly following Le-fort I advancement, while there was no significant change after anterior maxillary distraction and DOM. The ratio of soft tissue to hard tissue changes was greatest with AMD, followed by DOM and then CLO. Distraction osteogenesis of the maxilla and AMD are plausible treatment options for cleft maxillary advancement. Due to less stability and restricted amount of possible advancement, Le-fort I osteotomy should be reserved for minor skeletal discrepancies in cleft patients.


How to cite this article:
Mistry TA, Mistry A. Comparison of conventional Le-fort I advancement, anterior maxillary segmental distraction, and distraction osteogenesis of maxilla for surgical management of cleft maxillary hypoplasia: A systematic review.J Cleft Lip Palate Craniofac Anomal 2021;8:49-55


How to cite this URL:
Mistry TA, Mistry A. Comparison of conventional Le-fort I advancement, anterior maxillary segmental distraction, and distraction osteogenesis of maxilla for surgical management of cleft maxillary hypoplasia: A systematic review. J Cleft Lip Palate Craniofac Anomal [serial online] 2021 [cited 2021 Mar 1 ];8:49-55
Available from: https://www.jclpca.org/article.asp?issn=2348-2125;year=2021;volume=8;issue=1;spage=49;epage=55;aulast=Mistry;type=0