Treatment Experience With Midfacial Distraction Osteogenesis for Down Syndrome

Patients with Down syndrome have special characteristics, such as a round flat face, epicanthal fold, up-slanting palpebral fissures, flat nasal bridge, relative macroglossia, midfacial hypoplasia, short stature, short neck with extra skin at the nape, muscle hypotonia, ligament laxity, and joint hypermobility. Some of these characteristics can lead to obstructive sleep apnea. Epicanthal fold, up-slanting palpebral fissures, flat nasal bridge, and relative macroglossia are candidates for plastic surgery treatment. However, to the best of the authors' knowledge, there have been no reports of midfacial distraction osteogenesis for respiratory disorders associated with midfacial hypoplasia in patients with Down syndrome. Therefore, the authors reported the authors' successful experience in performing Le Fort II distraction osteogenesis surgery using a halo-type external distraction device in a 2-year-old boy with Down syndrome. Regardless of the good results, patients with Down syndrome usually have weakened respiratory muscles, so the indication for this procedure should be carefully considered and caution should be taken.