©2003 by Monduzzi Editore S.p.A.  MEDIMOND Inc. 211 D702C0038 Further Experiences in Midfacial Advancement without Maxillary Osteotomy P. Pellerin, N. Capon-Desgardin, P. Dhellemmes and M. Vinchon Department of Craniofacial Surgery, University Hospital, Lille, France The preliminary report of this technic that we have presented in 1999 at the first International congress of craniofacial distraction has been confirmed; today we have the experience of eleven consecutive cases in which the midface have been advanced in a very significant way with- out maxillary osteotomy. Aim of the Study To be able to treat the midfacial retrusion as soon as possible: simul- taneously with the primary surgery for intracranial hypertension. Without increasing the risk of communication between the extra- dural space and nasal fossa and its consequence the infection. Without producing scaring which could obviate further procedures of midfacial advancement. Why an Early Treatment of Midfacial Retrusion? Of course because it is useful: To cure the exophtalmia. To enlarge the cavum in order to avoid sleep apnea and prevent middle ear involvement. To advance the maxilla in order to correct the class III malocclusion and sleep apnea. But too, to work on an immature skeleton and catch the opportunity of a distraction without maxillary osteotomy. Why Do Not Perform a Maxillary Osteotomy? The reason why children with craniofaciostenosis are operated on as soon as possible is the intracranial hypertension. The most common