The combined results of Henry's earlier reconstructive surgeries overall have been good, but as he grows his midface region is compacting inward in relation to his lower jaw. This requires correction. So on Monday a surgical team will make some long cuts to the bone on each side of the upper maxilar portion of his face, then something called a rigid external distraction (RED) device will be attached to his skull. The initial surgery will require about 3 days in the hospital after which the device, which looks sort of like a metal halo, will need to stay on for roughly 30 to 90 days. For a little more than three weeks we will need to adjust the device each day to slowly extend the middle portion of his face outward. Next, Plan A would remove the device sometime just before Christmas in another surgery that would imbed plates and more grafted bone to secure the outward extension. If the condition of the surrounding bone won’t support the plates, Plan B would keep the device attached for up to 60 additional days, hoping for supporting bone to grow. Both plans each have competing advantages and disadvantages. In any event, we have no plan to send Henry back to school until the device is removed.
|The RED device|
In advance, his doctors have discussed the fine details of what's ahead with Henry. He is 11 now and in 5th grade. He says he's ready, and we can tell that he is mentally preparing himself.
As with the Abbe flap we found a number of articles in medical journals that described midface distraction procedures and the varying techniques used to perform them. But the articles were intended for surgeons. We could find little information intended to prepare parents or patients with what to expect. So we'll post again as things progress to provide some of this practical information here.