Maxillomandibular Tandem Osteotomy With Distraction Osteogenesis for Hemifacial Microsomia

Abstract

Currently, simultaneous maxillomandibular distraction osteogenesis is a standard procedure for the correction of hemifacial microsomia. Many variations of the procedure have been reported. However, a common problem has been the extended duration of the procedure. In particular, the lengthy intermaxillary fixation period includes a prolonged distraction series that requires the restriction of oral food intake and creates significant stress for the patient, which has a profound effect on patient satisfaction. To avoid this stress, we have developed tandem osteotomy with distraction osteogenesis, termed the TODO procedure. The TODO procedure not only shortens the intermaxillary fixation period and the duration of therapy but also creates the ideal skeletal proportions, with horizontalization of the occlusal plane. The TODO procedure has the added benefit of producing a marked aesthetic improvement. The patient was extremely satisfied by the result and endured minimal stress.

Assessment and Identification of Improvement Areas for Facial Symmetry in Hemifacial Microsomia (Type IIB) Using Three-dimensional Measurements

“…HFM often exhibits significant asymmetry, as patients undergo upper/lower jaw osteotomy to improve malocclusion and facial appearance. 21 Conventional two-dimensional evaluations make it difficult to measure and assess the differences in the left-right movement, which involves rotation of the upper/lower jaws. As mentioned, this condition is characterized by hard and soft tissue malformation in the ear region, 7 , 22 lowering the reproducibility of frontal and lateral cephalograms.…”

“…The bone distraction began one week after the bone-cutting and continued until the target was achieved with 6-12 months of stabilization. 14 Five patients (three men and two women), average age 22.2 years (19)(20)(21)(22)(23)(24)(25)(26)(27)(28), were featured. CT data and medical records used for diagnosis one month pre/postsurgery were used for these patients.…”

Role of Solid Model Simulation Surgery for Hemifacial Microsomia

“…To address this problem, multi-vector distraction in multifocal distraction procedures can be used. To further shorten the duration of distraction, the TODO procedure has been developed and performed (Ogata et al, 2012). In this TODO procedure, the intermaxillary fixation (IMF) during the distraction period is not required and the patient can be allowed oral intake.…”