Plastic and Reconstructive Surgery·Practice and Skill Innovations
Primary clinical research of orthognathic surgery simultaneous mandibular ramus reconstruction for type M3 hemifacial macrosomia
Tianjia Zhang, Biao Li, Hao Sun, Zhixu Liu, Xudong Wang
Published 2019-03-25
Cite as Chin J Plast Surg, 2019, 35(3): 259-263. DOI: 10.3760/cma.j.issn.1009-4598.2019.03.009
Abstract
ObjectiveTo summarize the effect of simultaneous orthognathic surgery along with mandibular ramus reconstruction using costochondral graft, for adult M3 hemifacial macrosomia.
MethodsFrom November 2015 to October 2017, 5 adults diagnosed with M3 hemifacial macrosomia were treated. There were 3 males and 2 females, aged from 19 to 26 years. Le Fort Ⅰ osteotomy and SSRO with simultaneous mandibular ramus reconstruction using contralateral sixth or seventh costochondral graft was performed to correct the facial asymmetry and occluding relation. The data of clinical examination and CTs were collected at the time point of immediately postoperative, 1, 3, 6, 12 months after surgery. The facial symmetry, joint function, occlusion and 3D measurements in CT image reconstruction were analysed to evaluate the surgery outcome.
ResultsThe length of rib and costal cartilage ranged from 47 mm to 67 mm. All the costal cartilage grafts survived, and 4 patients got primary healing. All patients were followed for 2-13 months (with the mean follow-up of 8 months). The ratio of ramus length of affected side to normal side was over 80%. The occlusion was stable. The facial structures were satisfactory after 6 months.
ConclusionsOrthognathic surgery with simultaneous mandibular ramus reconstruction using costochondral graft is suitable for the adult severe hemifacial macrosomia, with satisfactory cosmetic and functional results. This method is easily performed with reliable graft survival rate, aesthetic facial structure and stable occlusion.
Key words:
Orthognathic surgery; Virtual surgery; Costochondral graft; Hemifacial microsomia; Adult
Contributor Information
Tianjia Zhang
Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
Biao Li
Hao Sun
Zhixu Liu
Xudong Wang