Le Fort IV + I Distraction Osteogenesis Using an Internal Device for Syndromic Craniosynostosis

Monobloc and Le Fort III distractions can improve midfacial hypoplasia, a characteristic feature of syndromic craniosynostosis. The purpose of treating midfacial hypoplasia is to improve exophthalmos and dental occlusion. Typically, in Le Fort III or monobloc distractions, the midface is mobilized en bloc, and the extent and direction of the mobilization is determined according to the preferred intermaxillary occlusion. However, to obtain the preferred functional and esthetic results while correcting midface hypoplasia, the most sensible approach is the use of different degrees of mobilization and vectors for the upper and lower halves of the midface. This report describes the case of an adolescent with Crouzon syndrome showing frontal recession exophthalmos and an anterior crossbite. His condition was treated with monobloc minus Le Fort I and Le Fort I distraction using only internal devices, which the authors have designated Le Fort IV plus I distraction.