Orthognathic Surgery in Craniofacial Microsomia

Abstract

Summary:Craniofacial microsomia is a broad term that covers a variety of craniofacial malformation conditions that are caused by alterations in the derivatives of the first and second pharyngeal arches. In general terms, diverse therapeutic alternatives are proposed according to the growth stage and the severity of the alteration. When craniofacial growth has concluded, conventional orthognathic surgery (Le Fort I osteotomy, bilateral sagittal split osteotomy, and genioplasty) provides good alternatives for MI and MIIA type cases. Reconstruction of the mandibular ramus and temporomandibular joint before orthognathic surgery is the indicated treatment for cases MIIB and MIII. The goal of this article is to establish a surgical treatment algorithm for orthognathic surgery on patients with craniofacial microsomia, analyzing the points that allow the ideal treatment for each patient to be chosen.

Orthognathic Surgery in Goldenhar Syndrome With a Rare Course of the IAN

“…28 However, traditional orthognathic surgery has shown to provide satisfactory results. 29 Once an individual is nearing skeletal maturity, the decision to perform mandibular sagittal osteotomies versus ATJR, or in combination, should be a point of discussion with the patient as the risks and possible complications differ between the 2 surgeries. Although the most common complications of sagittal osteotomies and ATJR in the nondevelopmentally affected mandible are trigeminal nerve injury 30,31 and facial nerve injury, 32,33 respectively, those affected with hemifacial microsomia often pose a higher risk of complications.…”

Poly(ε-Caprolactone) Resorbable Auxetic Designed Knitted Scaffolds for Craniofacial Skeletal Muscle Regeneration

“…where, A = Area of the fabric in square centimeters T = Thickness of the fabric in centimeters W = Weight of the fabric in grams, and D = Density of the fiber in g/cm 3 The thickness of the scaffolds was measured in their relaxed state according to the ASTM D1777 "Standard Test Methods for Thickness of Textile Materials". The standard density for PCL fibers [18] was 1.145 g per cubic centimeter.…”

“…The causes of the deformity are unknown, but it is thought to be the result of a genetic abnormality during embryo development [ 1 ]. The treatment involves a combination of four procedures, namely (i) reconstruction of the mandibular ramus, (ii) mandibular distraction and osteogenesis, (iii) bone grafting and (iv) orthognathic surgery, depending on the pathology and anatomy of the defect in the individual patient [ 3 ]. The corrective reconstructive surgery in young patients involves the repairing of deformed jawbones and facial structure followed by filling up the gap with a muscle graft, which has tensile and biological properties similar to healthy native tissue [ 3 ].…”

“…The treatment involves a combination of four procedures, namely (i) reconstruction of the mandibular ramus, (ii) mandibular distraction and osteogenesis, (iii) bone grafting and (iv) orthognathic surgery, depending on the pathology and anatomy of the defect in the individual patient [ 3 ]. The corrective reconstructive surgery in young patients involves the repairing of deformed jawbones and facial structure followed by filling up the gap with a muscle graft, which has tensile and biological properties similar to healthy native tissue [ 3 ]. Such muscle grafts can be obtained either by removal of tissue from the patient, an autograft, which results in morbidity and scar formation at the donor site, or by tissue engineering, however currently there is no FDA approved tissue engineering treatment in the USA.…”

“…Such muscle grafts can be obtained either by removal of tissue from the patient, an autograft, which results in morbidity and scar formation at the donor site, or by tissue engineering, however currently there is no FDA approved tissue engineering treatment in the USA. This latter approach provides a successful therapy to treat the same disease by avoiding the risk of donor site morbidity, but it involves generating viable tissue in the laboratory by culturing cells on a biocompatible and resorbable tissue engineering scaffold [ 3 , 4 ]. Previous attempts in tissue engineering for oral and craniofacial reconstruction are mostly associated with bone and cartilage tissue regeneration, with scaffolds fabricated from either metallic biomaterials, such as platinum and other alloys, or synthetic resorbable biomaterials, such as poly(lactide-co-glycolide) and polycaprolactone.…”