Our Hemifacial Microsomia Treatment: The Importance of Both Selecting the Plan for the Grade of Deformity and Orthodontic Management

Next to cleft lip and palate, hemifacial microsomia affects the most patients, but it is hard to say that a treatment procedure is already established. We treat hemifacial microsomia employing orthognathic surgery and orthodontic treatment during the growing period. It is important to select the plan suitable for the grade of deformity. For Pruzansky grade I, we have employed a one stage elongation of the mandibular ramus on the affected side by vertical osteotomy and orthodontic treatment. For grade II, we have devised a technique for simultaneous gradual distraction of both the mandible and maxilla. For grade III, costochondral grafting and orthodontic treatment are undertaken with a view to secondary surgery. For producing better results, it is indispensable to confine the collapse of the occlusion, and to keep the occlusion stable.