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Furthermore, the TRS avoids possible complications observed in patients treated with the internal expanders over time such as infection, extrusion and cranial bone changes, some of which may develop even in older children.1315 Unlike internal subcutaneous expanders, recruitment of skin through mechanical creep with the aid of the TRS is achieved mostly by tangential stretching, without exerting pressure on the skull

Recurrence and metastases are observed 20 years after diagnosis