An Adult Cleft Lip and Plate Patient Using a Maxillary Distractor by $Synthes^{(R)}$ : Report of a case

$Synthes^{(R)}$상악골 신장기를 이용한 성인 구개구순열 환자의 치험례

Generally, an adult cleft lip or/and palate patient shows some amount of maxillary deficiency due to limitation of bony growth caused by heavy scars resulted from previous operations such as a cheiloplasty and/or a palatoplasty at an early child age. To solve the problem, advancement of the maxilla is usually required during orthognathic surgery. However, severe tensional force resulted from heavy scars on the palate and/or the lip, as well as the bony defect at the cleft area limited sufficient advancement of the maxillary segment and finally caused relapse of the reposed maxilla. Therefore, distraction osteogenesis of the maxilla was introduced for the successful maxillary advancement inthose kinds of patients. As both hard and soft tissues can be simultaneously and gradually extended with this technique, tensional force caused by heavy scars opposed to forward movement of the maxilla can be reduced to an extent not to develop severe relapse of the advanced maxilla. Since distraction osteogenesis of the maxilla was applied as one of standard protocols for the treatment of the patients with severe maxillary hypoplasia dueto cleft lip and/or palate, the devices for the distraction was improved to control the vectors of distraction with better and more stable. We have treated a 23-year-old male cleft patient with a severe maxillary hypoplasia using a newly developed a maxillary distraction device and a RP model for a pre-operative simulation surgery. As a result, we could successfully move the maxilla as we designed pre-operatively and also reduce much of operation time. Therefore, we report of the case to share our experience with colleagues.