plastic Surgery
Stephan Strobel, Lewis Spitz, Stephen D. Marks in Great Ormond Street Handbook of Paediatrics, 2019
Hemifacial microsomia (HFM) is a congenital condition resulting in the underdevelopment of one, or more rarely both, sides of the face (between 5 and 30%). It is the second most common congenital craniofacial anomaly after cleft lip and palate with an incidence between 1 in 3,000 and 1 in 6,000 live births. Other terms for hemifacial microsomia include craniofacial microsomia, Goldenhar syndrome, lateral facial dysplasia, 1st and 2nd arch syndrome and otomandibular dysostosis.
Lengthening the Human Mandible by Gradual Distraction
Niall MH McLeod, Peter A Brennan in 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
The first patient was treated at 23 months for right hemifacial microsomia. An expansion of 18 mm was achieved which was stable at 17 months. The second patient underwent bilateral distraction at age 8 years and 2 months for Nager syndrome. Expansions of 24 mm and 22 mm respectively were achieved; however, a relapse of 5 mm was reported at 9 months. The patient, the oldest treated, reported normal lip sensation, although their scars were deemed to be unsatisfactory.
Temporomandibular Joint Disorders
R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne in Scott-Brown's Essential Otorhinolaryngology, 2022
Some TMJ findings are due to the failure of the condyle to develop, possibly secondary to inadequate blood supply in utero. This causes associated undergrowth of the ear, ear canal, joint, and fossa to varying degrees. Hemifacial microsomia is a complex craniofacial disorder and management should involve supraregional craniofacial centres.
Surgical repair for transverse facial cleft: two flaps with a superiorly rotated single Z-plasty lateral to the commissure
Published in Journal of Plastic Surgery and Hand Surgery, 2019
Pan Zhou, Lin Qiu, Yan Liu, Tianwu Li, Xionghui Ding
Twenty-seven patients with transverse facial cleft underwent the same technique between 2008 and 2017. They were followed up for at least 6 months. The maximum duration follow-up was nearly 10 years. No infection and erosion were observed, and all of them attained primary healing. All the patients achieved natural and symmetrical commissure. The postoperative symmetric commissure was obtained owing to complete contraction with the new commissure directed 2 or 3 mm medial to the symmetrical point on the lips individually. Lateral displacement of the reconstructed commissure was not observed. The patients showed a plump and symmetrical cheek of the cleft side. Twenty-one patients with hemifacial microsomia achieved prominent improvement as compared with the preoperative appearance, although the postoperative cheeks still did not show fullness because of the lesser facial tissue on the cleft side. Twenty-seven patients were all without a conspicuous scar at the commissure. In the early follow-up period, most patients showed a minimal scar during movement. However, in the course of follow-up, the scar became thinner and symmetrical oral movement was achieved.
Efficacy of immediate physiotherapy after surgical release of zygomatico-coronoid ankylosis in a young child: A case report
Published in Physiotherapy Theory and Practice, 2022
Krzysztof Dowgierd, Anna Lipowicz, Małgorzata Kulesa-Mrowiecka, Wojciech Wolański, Paweł Linek, Andrzej Myśliwiec
This report presents the physiotherapy intervention and outcomes of the treatment of a female child between 1 and 4 years of age, born in the Silesian region of Poland. The child was born from a second pregnancy, and based on the number of erupted teeth (dental age estimation), child development was classified as typical. No history of bone defects was reported in the parents or in close relatives. Immediately after birth, the pediatrician diagnosed the child’s oral cavity disorders, consisting of the inability to open the jaws, and referred the girl to an orthodontist for consultation. The first diagnosis was made 5 days after birth by a specialist in the field of craniofacial defects with many years of experience, who diagnosed the child with hemifacial microsomia. From the functional standpoint, a limited mandibular depression and a right occlusal fissure larger than the left one was observed. An active suction reflex was also found, but with no tongue extension between the upper and lower alveolar ridges. The lower part of the left ear lobe was smaller than that on the right. The child was referred to an extended specialist consultation in the Center for Facial Craniofacial Defects and Maxillofacial Surgery in Olsztyn, Poland. At age 16 months, a computed tomography (CT) scan was obtained to diagnose congenital TMJ ankylosis. The girl was qualified for surgery to release the function of the left TMJ joint.
Posterior semi-circular canal electrode misplacement in Goldenhar’s syndrome
Published in Cochlear Implants International, 2021
Ashish Castellino, Pabina Rayamajhi, Rahul Kurkure, Mohan Kameswaran
A routine clinical examination documented a right hemifacial microsomia with maxillary hypoplasia, bilateral microtia and left EAC atresia. Audiological evaluation revealed bilateral profound SNHL on BERA with absent OAE. Tympanometry showed a type A curve on the right, and the aided audiogram demonstrated no benefit with hearing aid use. Imaging with HRCT temporal bones showed a normal right external auditory canal, atretic left external auditory canal with bilateral contracted diploic mastoids, absent antra, hypoplastic middle ear spaces with single dysmorphic ossicles, bilateral hypoplastic cochleae, aplasia of both lateral SCC but normal posterior & superior SCC and normal internal auditory canal anatomy (Fig. 1). MRI showed bilateral normal VII & VIII cranial nerve complexes at the cerebellopontine angle and normal brain anatomy. The implant programme multidisciplinary team (MDT) consultations confirmed cochlear implant candidacy and the right ear was chosen.
Related Knowledge Centers
- Birth Defect
- Mandible
- Phenotype
- Sensorineural Hearing Loss
- Trachea
- Tracheotomy
- Treacher Collins Syndrome
- Cleft Lip & Cleft Palate
- Microtia
- Sequence