No evidence for long-term effectiveness of early osteodistraction in hemifacial microsomia

Plast Reconstr Surg. 2009 Dec;124(6):2061-2071. doi: 10.1097/PRS.0b013e3181bcf2a4.

Abstract

Background: The authors performed a critical literature review to find evidence of the long-term stability after early distraction osteogenesis of the mandible in patients with hemifacial microsomia.

Methods: The PubMed, Cochrane, MEDLINE, EMBASE, CENTRAL, and CINAHL databases were searched systematically for studies performed between 2002 and 2008. Abstracts from the 89 relevant articles were reviewed for evidence.

Results: Thirteen articles met the inclusion criteria. Data were tabulated with respect to the length of follow-up, number of patients, age group, Pruzansky-Kaban classification of the patients, methods of analysis and validation, and level of evidence. Methods for long-term follow-up studies were not standardized, and no objective studies have been published on stability after growth cessation.

Conclusions: Thus far, no randomized controlled trials on early distraction osteogenesis in hemifacial microsomia patients have been published. The authors conclude that there is a lack of statistical evidence to support the use of early distraction osteogenesis for correcting hemifacial microsomia as a single treatment modality. The results call into question its rationale.

Publication types

  • Review

MeSH terms

  • Child, Preschool
  • Facial Asymmetry / congenital*
  • Facial Asymmetry / diagnosis
  • Facial Asymmetry / surgery*
  • Facial Bones / abnormalities
  • Facial Bones / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mandible / abnormalities
  • Mandible / surgery*
  • Osteogenesis, Distraction / adverse effects
  • Osteogenesis, Distraction / methods*
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods
  • Prospective Studies
  • Retrospective Studies
  • Risk Assessment
  • Time Factors
  • Treatment Outcome