Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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THE USE OF DISTRACTION OSTEOGENESIS TO TREAT HEMIFACIAL MICROSOMIA: A CASE REPORT

반안면 왜소증 환자에서의 골신장술: 증례보고

  • Baik, Sung-Mun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Kim, Su-Gwan (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Kim, Hak-Kyun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Moon, Seong-Yong (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University)
  • 백성문 (조선대학교 치과대학 구강악안면외과학교실) ;
  • 김수관 (조선대학교 치과대학 구강악안면외과학교실) ;
  • 김학균 (조선대학교 치과대학 구강악안면외과학교실) ;
  • 문성용 (조선대학교 치과대학 구강악안면외과학교실)
  • Published : 2007.10.31
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Abstract

Distraction osteogenesis(DO) is a surgical method of bone formation that involves an osteotomy and sequential stretching of the healing callus by gradual movement and subsequent remodeling. DO is used to correct facial asymmetry, such as in patients with hemifacial microsomia, maxillary or mandibular retrusion, cleft lip and palate, alveolar defects, and craniofacial deficiency. It is accomplished with the aid of a distraction device, which is secured with screws placed directly into bone, for a predetermined length of time. Hemifacial microsomia is characterized by unilateral facial hypoplasia, often with unilateral shortening of the mandible and subsequent malocclusion. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, tilted occlusal plane, and short mandible. Early treatment is necessary to avoid subsequent impaired midfacial growth. The standard treatment of these malformations consists of the application of bone grafts, which can lead to unpredictable growth. The new bone-lengthening procedure represents a limited surgical intervention and opens up a new perspective for treatment, especially in younger children with severe deformities. This report describes a case of hemifacial microsomia(Type-II left-sided hemifacial microsomia). The patient, a 10-year-old child, visited our clinic for facial asymmetry correction. He had a hypoplastic mandible, displaced ear lobe, 10 mm canting on the right side, and malocclusion. We planned DO to lengthen the left mandible in conjunction with a Le Fort I osteotomy for decanting and then perform a right intraoral vertical ramus osteotomy(IVRO). Progressive distraction at a rate of 0.5 mm/12 hours was initiated 7 days postoperatively. The duration of DO was 17 days. The consolidation period was 3 months. Satisfactory results were obtained in our case, indicating that DO can be used successfully for functional, aesthetic reconstruction of the mandible. We report a case involving DO in conjunction with orthognathic surgery for correcting mandibular hypoplasia with a review of the literature.

Keywords

References

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