Surgical correction of the midface in craniofacial microsomia. Part 1: A systematic review

Abstract

Types I/IIa benefited from LeFort + MDO; Type IIb from LeFort + MDO or BiMax; and Type III from BiMax (with 50% of cases having preceding mandibular procedures, including patient-fitted prosthesis) at a mean age of 20.2 years. Four studies recommended additional (esthetic) procedures.

Treatment modalities for Korean patients with unilateral hemifacial microsomia according to Pruzansky–Kaban types and growth stages

“…When the Pruzansky–Kaban type worsened from type I to type III, the number of patients who underwent surgical procedures was increased up to 4.2 times ( p < 0.001). This finding was similar to the results of systematic analysis conducted by van de Lande et al 17 …”

“…When the Pruzansky-Kaban type worsened from type I to type III, the number of patients who underwent surgical procedures was increased up to 4.2 times (p < 0.001). This finding was similar to the results of systematic analysis conducted by van de Lande et al 17 Comparison of the mean number of surgical procedures that each patient underwent (Table 8) The finding that the mean number of surgical procedures that each patient underwent increased from the type I group to the type III group, despite the lack of statistical significance (type I, n = 1.1; type IIa, n = 1.5; type IIb, n = 1.6; and type III, n = 2.3) was similar to that of Pluijmers et al 18 (type I, n = 1.0; type IIa, n = 1.4; type IIb, n = 1.8; and type III, n = 2.3).…”

“…Although unified consensus regarding the indications, optimal method, and optimal timing for the surgical treatment of HFM is still insufficient, the severity of mandibular deformity in HFM patients ( Figure 1) is one of the most important factors in determining the treatment method and predicting prognosis after treatment. 3,5,[13][14][15][16][17][18] There are two aspects to consider in surgical correction of HFM patients. First, the long-term outcome of surgical treatment is dependent on the severity of the mandibular deformity and facial asymmetry, rather than the type of surgical treatment (i.e., HFM patients with Pruzansky-Kaban type I and IIa exhibited stable results compared to those with Pruzansky-Kaban type IIb and III).…”

“…Although unified consensus regarding the indications, optimal method, and optimal timing for the surgical treatment of HFM is still insufficient, the severity of mandibular deformity in HFM patients ( Figure 1 ) is one of the most important factors in determining the treatment method and predicting prognosis after treatment. 3 , 5 , 13 - 18…”

Three-dimensional characterization of mandibular asymmetry in craniofacial microsomia

“…Nevertheless, no consensus exists on treatment protocols regarding technique, sequence, or timing because of lack of agreement about asymmetric growth and high phenotypical heterogeneity of the mandibular deformity. In the meantime, the Pruzansky-Kaban classification system, which is based on the severity of temporomandibular joint and mandibular deformity, is the most commonly used tool in planning interventions [20,21]. Although this system was developed based on two-dimensional (2D) radiography, it can be applied in modern three-dimensional (3D) images (i.e., computed tomography [CT] or cone-beam CT [CBCT]) [4].…”