Clinical Outcomes in Orthognathic Surgery for Craniofacial Microsomia Following Mandibular Distraction Using CBCT Analysis: A Retrospective Study

Cleft Palate Craniofac J. 2024 Mar;61(3):483-491. doi: 10.1177/10556656221131855. Epub 2022 Oct 7.

Abstract

Objective: The aim of this study was to evaluate the outcomes of orthognathic surgery (OGS) in patients with craniofacial microsomia (CFM) who had previously undergone mandibular distraction osteogenesis (MDO).

Design: A retrospective cohort study was performed including all patients with CFM who were treated with OGS at a single institution between 1996 and 2019. The clinical records, operative reports, and cone beam computed tomography (CBCT) scans were reviewed. CBCT data before OGS (T1), immediately after OGS (T2), and at long-term follow-up (T3) were analyzed using Dolphin three-dimensional software to measure the occlusal cant and chin point deviation.

Results: The study included 12 patients with CFM who underwent OGS (6 underwent OGS without MDO and 6 underwent OGS after MDO). There was a statistically significant improvement in occlusal cant and chin point deviation in both groups postoperatively. Occlusal cant relapsed by a mean of 0.6° (standard deviation [SD] 1.1°) in the patients who had OGS alone compared with 0.7° (SD 1.2°) in the patients who had OGS after MDO (P = .745) between T2 and T3. There was no statistically significant difference in chin point relapse between patients who had OGS alone compared with those who had OGS after MDO (0.1 mm [SD 2.5mm] vs 0.7mm [SD 2.2mm]; P = .808).

Conclusions: Within the limitations of this study, these findings suggest that OGS after MDO in patients with CFM can produce stable results.

Keywords: distraction osteogenesis; hemifacial microsomia; orthognathic surgery.

MeSH terms

  • Goldenhar Syndrome* / diagnostic imaging
  • Goldenhar Syndrome* / surgery
  • Humans
  • Mandible / diagnostic imaging
  • Mandible / surgery
  • Orthognathic Surgery*
  • Osteogenesis, Distraction* / methods
  • Retrospective Studies
  • Spiral Cone-Beam Computed Tomography*
  • Treatment Outcome