SummaryDistraction osteogenesis has been extensively used to correct severe midface hypoplasia in syndromic craniosynostosis patients. However few studies have reported midface distraction outcomes through cephalometric evaluation.AimThe purpose of the present study was to evaluate outcomes with midface distraction rigid external device (RED) in patients with syndromic craniosynostosis, in terms of quantity of bone lengthening, skeletal stability and facial growth.Materials and methodsEleven patients were retrospectively evaluated in this study. Cephalometrics was carried out through three teleradiographies from each patient (T1 -before surgery; T2- immediate postop, rigth after distractor removal; T3 - late postop, obtained with a minimal interval of 12 months after surgery).ResultsSignificant midface advancement was achieved with the procedure. The rate of horizontal relapse was minimal. We noticed a clear vertical facial growth, contrary to what was seen in the horizontal aspect, when there was a mild posterior relapse and no growth evidence.ConclusionCephalometric evaluation showed adequate results in midface bone lengthening with rigid external distractor.