Orthognathic treatment of hemifacial microsomia

Objective To explore the methods of orthognathic treatment for hemifacial microsomia.Methods Eleven cases of hemifacial microsomia were treated by Lefort I osteotomy,sagittal split ramus osteotomy,mandibular angle osteotomy,and genioplasty respectively,and repaired by four fibula flaps,three free scapular flaps and two abdomen derma-fat flap.The characteristics of the deformity,management of the cases,and the effects of therapy were analyzed respectively.Results The postoperative process of the eleven patients was uneventful.All the free flaps survived with the overall success rate of 100%.Facial appearance and oral function were improved greatly.Complete horizontalization of the occlusal plane was achieved in five of the patients,whereas a cant of 1～4 degrees persisted in the other patients.No permanent complication and no evidence of relapse were observed in any patient during the follow-up time.The corrective result was satisfactory.Conclusion Different operative methods were used according to the type of hemifacial microsomia.All the patients obtained satisfactory facial appearance and oral functions with pre-and post-operative orthodontic treatments.The application of free flaps extended the operative indication of hemifacial microsomia.