Consolidation Time and Relapse: A Systematic Review of Outcomes in Internal versus External Midface Distraction for Syndromic Craniosynostosis

Plastic and Reconstructive Surgery
Anthony A BertrandJustine C Lee

Abstract

The choice between internal and external distraction osteogenesis for midface advancement in patients with syndromic craniosynostosis is based primarily on surgeon preference and expertise. However, differences in outcomes between the two techniques have been sparingly compared. In this work, the authors performed a systematic review to compare outcomes between internal versus external midface distraction. A systematic review was performed of studies published between 1998 and 2018 (61 studies included; n = 689 patients). Operative characteristics, early reoperations, complications, and relapse rates were extracted. Bias evaluation was performed using the Newcastle-Ottawa instrument. Statistical analyses were performed with independent samples t tests and linear regression analyses (p < 0.05 considered significant). The authors found that external distraction was associated with more Le Fort III osteotomies and hardware adjustments (p = 0.023), whereas internal distraction was associated with more monobloc osteotomies and longer consolidation times (p = 0.008). No significant differences in the distance of midface advancement, reoperations, complications, or relapse rates were noted between internal versus external distraction,...Continue Reading

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Citations

Nov 3, 2020·The Journal of Craniofacial Surgery·Cristiano TonelloNivaldo Alonso
May 31, 2021·Clinics in Plastic Surgery·Waleed GibreelJeffrey A Hammoudeh
Jun 9, 2021·Journal of Orthodontics·Tulika TripathiPriyank Rai
Jun 30, 2021·Current Opinion in Otolaryngology & Head and Neck Surgery·Henya Sandhaus, Matthew D Johnson

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