Outcomes and Complications of Monobloc Versus Le Fort III Procedures for Treating Craniosynostosis: A Literature Review
Bassem Chamma, Suhas Nagappala, Mitchell Arnold, Sara Trumza, Kirollos Samir Tadrousse, Sahil Kapur, Mark Houdi, Richard SimmanBackground:
Craniosynostosis is a congenital disorder resulting in the early fusion of several bones in the skull, causing a deformity of the head and facial structures. The 2 most commonly performed surgical procedures to treat craniosynostosis include the monobloc and Le Fort III procedures. This literature review compares the functional and anatomical outcomes and complications between the monobloc and Le Fort III procedures for treating craniosynostosis.
Methods:
A PubMed search was conducted to identify studies assessing the outcomes following monobloc and Le Fort procedures. Data on anatomical changes, ophthalmic, airway, and neurological sequelae, as well as miscellaneous infectious or aesthetic complications were extracted from each study.
Results:
A total of 63 articles were included for analysis. The average length of midface advancement across distraction and nondistraction procedures was significantly higher in the monobloc cases (14.28 mm; 98.8% of patients with distraction) compared with Le Fort III cases (12.26 mm; 63% of patients with distraction) (
Conclusions:
In summary, this review demonstrates that both the monobloc and Le Fort III procedures are effective in producing maxillofacial advancement and correcting craniosynostosis, with the monobloc procedure demonstrating significantly greater average advancement. Future research should investigate the comparison of aesthetic and obstructive sleep apnea outcomes further.