Distracción ósea y cirugía ortognática en paciente previamente radiado

Abstract

IntroductionWe report the case of a patient who received radiotherapy in childhood for retinoblastoma. The main sequelae of this was, severe bone hemifacial hypoplasia, abnormal dentition, and muscle atrophy. Corrective facial surgery was performed through bone distraction, orthognathic surgery, and facial liposuction, with excellent and stable aesthetic and functional results to date. Casereport A 15 year-old patient with left temporo-parieto-frontal and orbital hypoplasia and midface hypoplasia with an inclined occlusal plane, overjet more than 25mm and multiple teeth with microdontia and rhizolysis. At 19 years old, presurgical orthodontics and placement of Zurich type maxillar distractors were started. An advancing of 25mm was achieved. At 21years old, bimaxillary orthognathic surgery and facial liposuction was performed. ResultsPatient improvement in facial symmetry, occlusion type i of Angle classification with inclined occlusal plane. Stable results to date on a 23 year-old patient. Continues with post-surgical orthodontic and dental rehabilitation. DiscussionGood bone consolidation was obtained, with excellent bone quality from a clinical and radiological point of view, with no complications. Another benefit is the distraction expanding effect of the soft tissue. Osteogenesis distraction and bimaxillary orthognathic surgery are promising methods in maxillofacial reconstruction on irradiated patients with dentofacial deformity as oncology sequelae.