Craniofacial and extracraniofacial anomalies in craniofacial microsomia: A multicenter study of 755 patients

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

“…The use of 3D computer-aideddesign and computer-aided-manufacturing principles are described as an accurate and reliable method in the diagnosis, treatment planning, and designing of cutting guides that optimize surgical correction in a small number of patients with hemimandibular hyperplasia and Class III malocclusion (Hatamleh et al, 2016;Hatamleh et al, 2017) Moreover, as recent studies suggest that asymmetry occurs from skull base and on, the mandible and maxilla seen as a continuum part of this. (Tuin et al, 2015;Caron et al, 2017) It could aid in these complex cases in which the standardized cephalometry does not apply. A Case report on the correction of a patient with CFM with the use of computer assisted orthognatic surgical protocol confirms the clinical feasibility.…”

“…Craniofacial microsomia, hemifacial microsomia, bimaxillary osteotomy, osteotomy, le Fort, mandibular distraction osteogenesis, systematic review INTRODUCTION Craniofacial microsomia (CFM) is a congenital malformation of the derivatives of the first and second pharyngeal arches; primary involving the lower-and mid-face; resulting in a heterogeneous phenotype of facial asymmetry. (Molina et al, 1995;Granstrom et al, 1999;Caron et al, 2017) A predominantly unilateral presentation is found in 88,6% of all patients. The right-left ratio in unilateral patients is reported 1,2:1; which is the same for the male-female ratio.…”

“…The right-left ratio in unilateral patients is reported 1,2:1; which is the same for the male-female ratio. (Caron et al, 2017) The deformity is captured through several grading systems. The most recent grading system: the Phenotypic Assesment Tool -Craniofacial Microsomia (PAT-CFM) (Birgfeld et al, 2011) follows the Pruzansky-Kaban system in describing the malformation of the mandible.…”

Part 2: Is the maxillary canting and its surgical correction in patients with CFM correlated to the mandibular deformity?

“…Recent studies report a correlation between the different regions of the craniofacial region mentioned above. (Tuin et al, 2015) (Caron et al, 2017)The studies find a stronger correlation between the structures with their origin in the first pharyngeal arch i.e. between the mandible, orbit and soft-tissue and those with their origin in the second pharyngeal arch i.e.…”

“…(Grabb, 1965;Heike et al, 1993;Birgfeld et al, 2012) The leading hypotheses on the aetiology include local haemorrhage of the stapedial artery (Poswillo, 1975) and disturbed migration of cranial neural crest cells. (Johnston et al, 1995;Tuin et al, 2015;Caron et al, 2017) With dysmorphologies ranging from mild to severe, patients with CFM are phenotypically heterogeneous. Multiple classification systems have been proposed to categorise and report the severity of the different anomalies.…”