Affiliation:
1. Morriston Hospital, Swansea Bay University Health Board, Maxillofacial and Cleft Units , Swansea , UK
2. Department of Plastic Surgery , Childrens Hospital of Philadelphia , Philadelphia , PA , USA
Abstract
Abstract
Objectives
This article describes the many anomalies within and outside the head and neck of hemifacial microsomia (HFM).
Methods
The OMENS+ classification system is described with particular reference to the mandibular features classified by Pruzansky and modified by Kaban. The application of virtual surgical planning (VSP) to HFM, largely in children, is described and taken through to aspects indicated in maturity.
Results
VSP is demonstrated with clinical cases examples in HFM patients for (1) grafts and flaps replacing missing parts of the zygomatic bone, temporo-mandibular joint and mandible, (2) distraction osteogenesis for lengthening of the mandibular ramus, advancement of the mandibular body, widening of the face and simultaneous mid-face and mandibular rotation, (3) implants and correction of microtia for bone anchored ear prostheses, (4) correction of microtia by autogenous ear construction, and (5) end stage rotational bimaxillary osteotomies.
Conclusions
3D virtual and physical planning is a valuable adjunct to the treatment of this complex condition.
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