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. 2024 May 28;12(5):e5810.
doi: 10.1097/GOX.0000000000005810. eCollection 2024 May.

Three-dimensional Hemifacial Microsomia Classification with New Subtypes Based on the Pruzansky and Kaban Classification

Reiko Shibazaki-Yorozuya  1 , Akira Yamada  2 , Ryo Sasaki  3 , Yorikatsu Watanabe  4
Affiliations

Three-dimensional Hemifacial Microsomia Classification with New Subtypes Based on the Pruzansky and Kaban Classification

Reiko Shibazaki-Yorozuya et al. Plast Reconstr Surg Glob Open. .

Abstract

Background: Various classifications of hemifacial microsomia (HFM) have been described previously. Although some of these classifications are used widely, others use external outlines of reference organs, even in three-dimensional (3D) images. The purpose of this study was to investigate the 3D characteristics of the mandibular condyle in HFM and to update the Pruzansky and Kaban classification as a 3D classification.

Methods: Fifty-three patients with HFM were classified according to the Pruzansky and Kaban classification (type I, IIA, IIB, and III) using computed tomographic scan images. 3D images of the mandible were isolated, and the 3D characteristics were observed; furthermore, the angle of inclination of the mandibular condyle was measured in 3D.

Results: Subtypes of retroflexed mandibular condyle in 3D were observed in the Pruzansky and Kaban classification type IIA and IIB, termed as type IIAβ (33.3% in type IIA) and type IIBβ (100% in type IIB). Although some differences were observed in the inclination of the mandibular condyle between the control and the affected sides in type I and IIAα, multiple differences were observed in type IIAβ and IIBβ.

Conclusions: To the best of our knowledge, this is the first report that identified the retroflexed mandibular condyle as subtypes type IIAβ and IIBβ. Notably, this could not be identified in the two-dimensional images (lateral cephalogram) yet. We proposed to update the Pruzansky and Kaban classification as a 3D classification with a new 3D subtype. The angle of the retroflexed mandibular condyle may predict mandibular growth in HFM.

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Conflict of interest statement

The authors have no financial interests to declare in relation to the content of this article.

Figures

Fig. 1.
Fig. 1.
Angle measurements of the retroflexed mandibular condyle.
Fig. 2.
Fig. 2.
Three-dimensional images of the affected-side mandibular condyle in hemifacial microsomia with the new Pruzansky and Kaban classification subtypes.
Fig. 3.
Fig. 3.
Three-dimensional images of the affected-side mandible and condyle in hemifacial microsomia with the new Pruzansky and Kaban classification subtypes.
Fig. 4.
Fig. 4.
Three-dimensional images of the affected-side maxillofacial region in hemifacial microsomia based on the Pruzansky and Kaban classification.
Fig. 5.
Fig. 5.
Three-dimensional hemifacial microsomia classification with new subtypes based on the Pruzansky and Kaban classification.
Fig. 6.
Fig. 6.
Reverse angle of the affected-side retroflexed mandibular condyle within the same subtype (type IIBβ).
Fig. 7.
Fig. 7.
Differences in MCA between the affected and control sides based on the Pruzansky and Kaban classification.
See this image and copyright information in PMC

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