Surgical correction of mandibular hypoplasia in hemifacial microsomia: A retrospective study in 39 patients

Purpose: Repair of the mandibular deformity in hemifacial microsomia (HFM) remains controversial, and there is scant information in the literature regarding the late outcomes. The aim of this study was to evaluate architectural and aesthetic long-term outcomes for primary mandibular surgery in patients with HFM. Materials and methods: Thirty-nine patients with types II and type III HFM were included in this retrospective study. Depending on the nature of the mandibular deformity, patients were treated using a costochondral graft (CCG) or a vertical ramus osteotomy (VRO). Architectural and aesthetic parameters were evaluated preoperatively, postoperatively, and at the end of the follow-up period. Results: The architectural analysis revealed the restoration of a level occlusal canting at the end of the follow-up period (p < 0.0001); the chin deviation was corrected immediately by the surgery, although a trend to recurrence was noted at the last follow-up evaluation (p < 0.0001). The aesthetic assessment revealed a significant improvement of the chin deflection, and correction of the lip commissural line tilt (p < 0.0001). Twenty-three percent of the patients required an additional orthognathic revision. Conclusion: CCG and VRO continue to be suitable and safe procedures with good outcomes that allow a single-stage correction of occlusion and preservation of mandibular growth in young patients with type II and type III HFM. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.