Dr. Boutros has pioneered the techniques of endoscopic mandibular distraction. Unlike earlier techniques that required large incisions on the face of the patient, endoscopic techniques use an approach through the inside of the mouth. As a result, the patient has almost no risk of injury to the delicate facial nerve, and the scars resulting from this approach are entirely located inside the mouth, providing an excellent concealment. Additionally, the technique provides enhanced bony regeneration of the mandible, while the activation arm of the device (used to move the device), is located below the chin through a small incision, easily concealed after the procedure.
What is Mandibular Distraction?
Distraction, or distraction osteogenesis, is a process by which new bone is formed via the gradual stretching of existing bones. With distraction osteogenesis, the bone is cut, a device is applied, and this device slowly separates the two bony ends. The gap that is gradually created fills with new bone formation. This exciting advance in surgery was first applied to the lengthening of lower extremity bones by a physician named Ilizarov. Ilizarov’s lengthening was generally performed in association with traumatic injuries to the lower extremities via complex external fixation devices. In the craniofacial skeleton, distraction works extremely well as the bones of the craniofacial skeleton heal both strongly and rapidly. Furthermore, complications which are commonly seen in the lower extremity, that is infection, non-union or fibrous union, are rarely seen in the craniofacial skeleton where the bone healing is much more vigorous.
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