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Effects of Midfacial Surgical Trauma and Rigid Plate Fixation

John F. Laurenzo, MD; John W. Canady, MD; M. Bridget Zimmerman, PhD; Richard J. H. Smith, MD

Arch Otolaryngol Head Neck Surg. 1995;121(5):556-561.

Abstract
Objective
To examine the effects of soft-tissue manipulation, rigid microplate fixation, and multiple osteotomies on the growing midface in rabbits.

Design
Randomized, controlled experiment.

Subjects
Forty 6-week-old male New Zealand white rabbits.

Interventions
Group 1, exposure of the left nasofrontal and midzygomatic arch regions with periosteal elevation; group 2, osteotomies at left nasofrontal suture and midzygomatic arch; group 3, rigid plate fixation of osteotomies; and group 4, rigid plate fixation alone. Animals were killed at age 20 weeks; growth was assessed by linear and spatial measurements of craniofacial regions.

Results
Linear data disclosed shortening of the left nasal bone (P<.05) in groups 2 through 4. Groups 3 and 4 also had shortened left zygomatic arches and orbital diameters (P<.05). Euclidean distance matrix analysis showed significant restrictive shape alterations in groups 2 through 4 (P<.05). Significant contralateral shape alterations also were found in group 3.

Conclusion
Rigid plate fixation does not cause more severe growth disturbance than bony trauma. Use of rigid plate fixation after bony trauma does not seem to increase the restrictive effects of trauma on growth. Furthermore, removal of rigid plate fixation may not prevent growth disturbances and may induce further harmful trauma to the growing midface.

(Arch Otolaryngol Head Neck Surg. 1995;121:556-561)

Author Affiliations
From the Departments of Otolaryngology (Drs Laurenzo, Canady, and Smith), Preventive Medicine (Dr Zimmerman), Surgery—Division of Plastic and Reconstructive Surgery (Dr Canady), University of Iowa Hospitals and Clinics, Iowa City.

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