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Surgery-Rigged pulley helps patients

Health's former chief of dental and craniofacial research. But it has ``enormous promise,'' he says - so much that some scientists are studying how to pair this grow-your-own-new-bone method with genetically engineered drugs to make that bone grow faster.

Surgeons have long lengthened leg bones by breaking them, pulling them apart and letting the body grow new bone - just as it would if you'd naturally broken your leg. Several years ago, a New York physician adapted that technique, called distraction osteogenesis, to fix malformed jaws.

If it worked on single bones, Poll reasoned, why not for children's entire faces. First, Polley operates to cut all the stunted, sunken facial bones, but he doesn't move them. Instead, he attaches wires to the skull or certain other bones. Those wires screw into to a halo-like device, designed with Rush dentist Alvaro Figueroa, worn in front of the face.

With a turn of a screwdriver twice a day, parents tighten the wires. That tightening moves the pieces of bone forward a millimeter a day. As that happens, the body manufactures new bone to fill the gap. Over six weeks, facial bones can be extended as much as the length of a paper clip.

Poll doesn't have long-term data yet proving the children will never need additional surgery. But the technique already is widely used for easier cleft palate repair, and Poll says only 5 percent of those patients relapse, fewer than with traditional surgical cleft repair.


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