Maxillary Growth Following LeFort III Advancement Surgery in Crouzon, Apert, and Pfeiffer Syndromes

This was a cephalometric study of maxillary growth following LeFort III osteotomy in children with Crouzon, Apert, and Pfeiffer (CAP) syndromes. Nineteen children who had undergone LeFort III advancement osteotomies were followed postoperatively for an average of 5.3 years. Data for horizontal and vertical maxillary growth increments were obtained and compared with data of a control group of unoperated CAP children and with normal data. The findings indicate that horizontal maxillary growth following surgical treatment is negligible (less than 0.1 mm/yr), and differs from unoperated CAP children (0.7 mm/yr) and normal children (1.3 mm/yr). Vertical maxillary growth following surgery is identical to that in unoperated CAP and normal children, amounting to 1.3 mm/yr. The LeFort III osteotomy during childhood is a justifiable procedure for physiologic and psychologic reasons. Horizontal maxillary growth, for all practical purposes, is eliminated by this procedure and a subsequent maxillary advancement is invariably required at the completion of growth.