Impact of Lefort III/ monobloc advancement on midface growth in children with syndromic craniosynostosis: A systematic review.

Syndromic craniosynostosis is a complex condition involving the craniofacial skeleton, often requiring surgical midface advancement (SMA) to address functional and aesthetic concerns. A systematic review of literature was conducted on the impact of Lefort III/monobloc advancement on midface growth of children with syndromic craniosynostosis. Comprehensive search of multiple databases yielded 21 studies that met the inclusion criteria. Data extraction and risk-of-bias assessment were performed using standardized tools. The review included 309 children who underwent SMA at a median age of 7-8 years. While some studies reported positive post-operative growth, others found no evidence of growth. The type of surgical intervention (osteotomy vs. distraction) and age at surgery did not consistently influence growth outcomes. Vertical growth of the midface was uninterrupted post-operatively, whereas sagittal growth was minimal. This systematic review highlights the variability in midface growth outcomes following LeFort III/monobloc advancement in children with syndromic craniosynostosis. Further research is needed to elucidate the factors influencing growth and to optimize surgical techniques for improved outcomes.