Costochondral Grafting in Craniofacial Microsomia

Tahiri, Youssef; Chang, Catherine S.; Tuin, Jorien; Paliga, J. Thomas; Lowe, Kristen M.; Taylor, Jesse A.; Bartlett, Scott P.

doi:10.1097/prs.0000000000000914

Cited by 54 publications

(46 citation statements)

References 36 publications

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“…Rib grafts, distraction osteogenesis of the hypoplastic mandible, and microtia surgery have been reported as surgical treatments for the facial deformity of HFM [ 9 , 10 ]. However, these treatment methods do not completely solve the esthetic problem.…”

Section: Introductionmentioning

confidence: 99%

An integrated surgical protocol for adult patients with hemifacial microsomia: Methods and outcome

Yamaguchi

Lonic

et al. 2017

PLoS ONE

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BackgroundHemifacial microsomia (HFM) features hypoplasia and asymmetry in skeletal as well as soft tissue, and correction of the deformity is difficult in terms of aesthetic outcome. The purpose of this study is to examine the validity of an integrated treatment protocol for correction of this facial deformity.Patients and methodsA retrospective study was performed on adult HFM patients who received two-jaw orthognathic surgery combined with facial contouring procedures in the first stage, and fat injection for the residual facial deficiency in the second stage. Inclusion criteria were patients treated by the same surgeon and follow-up at least 6 months. The demographic, perioperative, and follow-up data were collected. We defined a facial surface area discrepancy index (FDI) for objective assessment of the symmetry between the affected and non-affected side, and utilized visual analogue scale (VAS) for subjective evaluation of facial asymmetry before and after surgical treatment.ResultsA total of 14 patients were included. The mean age at orthognathic surgery was 21.7 years. Four patients were categorized as Pruzansky-Kaban type I, while the remaining 10 patients were type II (7 patients type IIA, 3 patients type IIB). Fat injection as a secondary procedure was performed in eleven cases (79%). The mean pre- and postoperative FDI was 87.6±6.3 and 95.4±5.2 with a significant advance for symmetry (p < 0.001). The pre- and postoperative VAS for asymmetry was 7.2±1.7 and 3.8±2.4 respectively, with a significant improvement (p = 0.002).ConclusionOur integrated approach using orthognathic surgery, facial contouring surgery and subsequent fat injection is satisfactory and obtain significant improvement of the facial deformity considering the complexity of HFM.

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Section: Introductionmentioning

confidence: 99%

An integrated surgical protocol for adult patients with hemifacial microsomia: Methods and outcome

Yamaguchi

Lonic

et al. 2017

PLoS ONE

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“…14 Tahiri et al documented 22 patients (33 grafts, 11 bilateral) and found clinically adequate growth in 27 rib grafts (81%). 15 Reconstructed loading of the TMJ, blunt dissection, size of the cartilage, and preservation of the periosteal/perichondrial sleeve were influential factors. 15,16 There were no complaints of pain in the TMJ in the unaffected side, and no limitations to mouth-opening, which indicates that there was no excessive stress on the condyle of the unaffected side that may lead to osteoarthritis and bony resorption.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of a new custom-made bone-supported osteotomy and repositioning guide system for reconstruction of the mandibular ramus using costochondral grafts: a preliminary study

Sun

Zhang

et al. 2020

British Journal of Oral and Maxillofacial Surgery

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“…To avoid introducing techniques that might harm patients, or at least be no better than the procedures that they In patients without a joint, the costochondral graft reconstruction during growth has been well documented and is successful. 71 The suggestion that when the joint is overgrown or inadequate that DO can be used was not considered logical as it is easier and simpler to graft or osteotomise at the end of growth. The vast majority of reports point out limitations in success using DO in growing children.…”

Section: Vascular Disturbancesmentioning

confidence: 99%

A critical analysis of the management of craniofacial microsomia

Ac¹

2018

Australas J Plast Surg

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Distraction Osteogenesis was introduced into the management of Craniofacial Microsomia some decades ago. It assumed almost instant popularity without evidence of advantage. Poor long-term results and high rates of relapse prove this technique is unsuitable for all but the most carefully selected patients. While innovation and technological advances are to be celebrated, it is vital that new procedures are rigorously tested against current protocols. It is also imperative, that thorough knowledge of disease pathology and pathogenesis are applied against new procedures. It is the view of the author that many painful, useless operations would be avoided if surgeons better understood these key fundamentals. Furthermore, there must be clear guidelines for the introduction of new techniques and devices, and this must happen independently of manufacturers.

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Costochondral Grafting in Craniofacial Microsomia

Abstract: Therapeutic, IV.

Cited by 54 publications

References 36 publications

An integrated surgical protocol for adult patients with hemifacial microsomia: Methods and outcome

An integrated surgical protocol for adult patients with hemifacial microsomia: Methods and outcome

Accuracy of a new custom-made bone-supported osteotomy and repositioning guide system for reconstruction of the mandibular ramus using costochondral grafts: a preliminary study

A critical analysis of the management of craniofacial microsomia

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