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. 2016 Sep-Dec;6(3):241-245.
doi: 10.1016/j.jobcr.2016.05.002. Epub 2016 Jun 18.

A novel step osteotomy for correction of hemifacial microsomia - A case report

Debraj Howlader  1 , Dichen P Bhutia  1 , U Vignesh  1 , Divya Mehrotra  1
Affiliations

A novel step osteotomy for correction of hemifacial microsomia - A case report

Debraj Howlader et al. J Oral Biol Craniofac Res. 2016 Sep-Dec.

Abstract

Facial asymmetry is one of the commonest facial anomalies, with reported incidence as high as 34%. Hemifacial microsomia (HFM) has an incidence of 1 in every 4000-5600 children and is one of the commonest causes of facial asymmetry. The standard treatment of HFM is orthognathic surgery by bilateral saggital split osteotomy (BSSO) or distraction osteogenesis (DO) of the mandible, both of which involve prolonged periods of occlusal adjustments by an orthodontist. Here, we present distraction of the mandible by means of a novel modified step osteotomy to correct the facial asymmetry in a case of hemifacial microsomia without disturbing the occlusion. This novel technique can prove to be a new tool in the maxillofacial surgeons armamentarium to treat facial asymmetry.

Keywords: Bilateral saggital split osteotomy (BSSO); Distraction osteogenesis (DO); Genioplasty; Hemifacial microsomia (HFM); Novel step osteotomy.

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Figures

Fig. 1
Fig. 1
Frontal view of the patient.
Fig. 2
Fig. 2
Profile photographs of the patient.
Fig. 3
Fig. 3
Intra-oral view of the patient.
Fig. 4
Fig. 4
Orthopantomograph of the patient.
Fig. 5
Fig. 5
A diagrammatic representation of the “modified stepped osteotomy” outlined on a normal mandible.
Fig. 6
Fig. 6
Distractor placement after completion of osteotomy.
Fig. 7
Fig. 7
(A) Medpore augmentation of angle of mandible. (B) Harvesting of dermal fat. (C) Fat augmentation of the angle of mandible.
Fig. 8
Fig. 8
Lateral sliding genioplasty.
Fig. 9
Fig. 9
One-month postoperative photograph of the patient.
See this image and copyright information in PMC

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