ABSTRACT
Since its introduction in the medical literature in 1992 by McCarthy, distraction osteogenesis of the craniofacial skeleton has become a standard surgical therapy. The present report attempts to trace the development of craniofacial distraction from the perspective of one of the early proponents of the technique. Although the earliest application of distraction was in children with severe unilateral or bilateral mandibular deficiency, its use for functional abnormalities such as apnoea were especially appealing. Distraction osteogenesis for the midface began with external appliances that were attached to the teeth. Newer, buried devices have eliminated the need for external devices in all LeFort III and monobloc cases. For LeFort I and mandibular cases, the ideal internal device has not been manufactured.
The concept of distraction osteogenesis was championed by Ilizarov, beginning as early as 1954, for the treatment of a variety of congenital and acquired deformities of enchondral bone. In 1973, Snyder and associates reported on gradual distraction of the mandible using an extraoral device in canines.
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