Management of Severe Midface Retrusion With Distraction Osteogenesis in Patients With Cleft Lip and Alveolus.

A cleft lip, palate, and alveolus is one of the most common birth defects. Depending on the type of cleft, multiple surgeries may be required throughout the growth stage. Traditionally, an orthodontic-surgical approach has been adopted to treat maxillary retrusion. Osteodistraction it is the surgical choice in patients with severe midface retrusion that require maxillary advancement. Our objective is to present our experience using this orthodontic and surgical approach.

Mandibular Reconstruction for Pediatric Patients.

: Mandibular reconstruction in pediatric patients is controversial. The scant pediatric experience and the infrequent occurrence of this type of pathology in children complicate therapeutic decisions. The literature contains different treatment protocols and describes the bone graft alternatives to be used. MATERIALS AND METHOD: This is a retrospective review of patients under the age of 15 who were subjected to resection and reconstruction. RESULTS: A total of 18 patients were included in the study: 8 women and 10 men. The age on the date of diagnosis ranged from 2 years to 13 years and the average was 7 years. Five patients underwent resective surgery for a malign pathology, 7 for a benign pathology, 4 for aggressive lesions of odontogenic origin, and 1for the effects of a fracture that was complicated by osteomyelitis. CONCLUSIONS: In conclusion, treating pediatric patients with tumor pathology requires an experience pediatric team to get good outcomes. Surgeons must consider that pediatric patients are in constant growth and development but that must not be an issue in resection and reconstruction decisions. Literature review shows that, as in adults, free flaps seem to be the criterion standard for big resections in mandibles defects, and are safe to use in pediatric patients.

Remodeling of Costochondral Graft After Mandibular Reconstruction.

Mandibular tumors are rare in children. Most mandibular tumors in children are benign and locally aggressive, and some might require resection to prevent recurrence. Mandibular reconstruction after tumor resection in children has been less documented in published studies than mandibular reconstruction in adults. In children, age, the growth potential of the mandible, and the donor site are important factors that must be considered. The costochondral graft is an option for reconstruction of the resected portion of the mandible in children, especially when the resection involves the condyle, owing to its biologic and anatomic similarity to the temporomandibular joint and its regenerative and growth potential. The objective of the present case report is to present the unusual remodeling of a nonvascularized costochondral graft after mandibular resection in a pediatric patient.