Simultaneous distraction osteogenesis of the maxilla and mandible combined with second-stage orthognathic surgery for correction of hemifacial microsomia in adults

Objective To explore the clinical effect of simultaneous distraction osteogenesis of the maxilla and affected mandible combined with second-stage orthognathic surgery for the treatment of adult hemifacial microsomia to provide a reference for clinical practice.Methods Twelve adult patients with hemifacial microsomia who underwent simultaneous distraction osteogenesis and second-stage orthognathic surgery from 2006 to 2013 were enrolled. Distraction osteogenesis of the maxilla and malformed lateral mandible and second-stage orthognathic surgery were performed according to each patient’s specific conditions. The height ratio of the mandibular ramus of the affected side to the contralateral side, the shift distance of the chin point and the inclination angle of the screw plane were measured before and after the operation, and the therapeutic effect was evaluated with clinical photographs.Results No patients had obvious complications after the operation, the postoperative aesthetic effect was good, and the relationship between the facial shape and occlusion was significantly improved. The cephalometric measurement showed that the height ratio of the mandibular ramus of the affected side to the contralateral side was increased by 23.83% (t=11.658, P<0.001), the deviation distance of the chin was corrected, and the chin point moved back to the midline by 6.63 mm (t=13.042, P<0.001) on average, and the inclination angle of the occlusal plane was improved and returned to the horizontal plane by 8.83° (t=15.358, P<0.001) on average.Conclusion The application of simultaneous distraction osteogenesis of the maxilla and mandible combined with secondary orthognathic surgery for the treatment of adult hemifacial microsomia can obtain satisfactory clinical and aesthetic results and has clinical value.