Distraction osteogenesis can be applied to all surgeries of the skull and face that require moving bones, such as cranial vault remodeling, fronto-orbital advancement, Le Fort III, Le Fort II and Le Fort I. It involves the same cuts, but includes the placement of either internal or external distractors. Once the bones start to mend, typically three to five days after surgery, your child’s surgeon will begin turning the distractors. This stage lasts approximately two to three weeks, and gradually moves the midface forward.
A second procedure is required to remove the distraction device. If your child is followed by a Craniofacial team, they will return for follow-up appointments once or twice a year. At these visits, doctors may use 3-D CT scans to monitor your child for continued growth of the cranial vault and midface.
In distraction osteogenesis, expanding the soft tissue envelope in addition to the posterior cranial vault allows for significantly greater expansion and relief of intracranial pressure. This procedure is beneficial for patients with raised pressure who are too young to undergo fronto-orbital advancement. It can also improve function and appearance more than a second FOA in some patients, limiting the need for subsequent procedures. It is also typically associated with a lower rate of complications, especially in older children.