Incidence of Oblique Traction Vector of the Pterigomasseteric Sling in Relapse of Mandibular Distraction Osteogenesis after Proportional Overcorrection in Goldenhar Syndrome: Case Report

Distraction osteogenesis in the facial territory is a very useful tool in patients with dysmorphosis and syndromes. It allows histiogenesis after progressive traction of the intervened bone tissue, which increases in size according to the planned vector and the range of distraction. The existence of post-distraction osteogenic relapse depends on multiple factors. In the maxillary region, it corresponds to approximately 10% of the total number of millimetres (mm) distracted. Anatomical and biomechanical factors play a fundamental role in the variability of these results. The purpose of our work is to present the results obtained after vertical distraction of the mandibular ramus in a pediatric patient with Goldenhar syndrome. Following a proportional overcorrection, an asymmetric relapse was evident in the postoperative 3D measurements, with a greater relapse at the posterior border of the mandibular ramus. Additionally, we provide a literature review regarding the possible role of the pterygomasseteric sling vector of forces in the postoperative outcomes of these patients.