Mandibular distraction osteogenesis in hemifacial microsomia: long-term follow-up.
OBJECTIVE
Prospective, longitudinal, clinical long-term follow-up study of a homogeneous sample of children affected by hemifacial microsomia and treated by mandibular distraction osteogenesis.


METHODS
Eight patients affected by types I and II hemifacial microsomia were operated on at an average age of 5.6 years with an average follow-up of 5.8 years.


METHODS
Vertical changes were measured on postero-anterior cephalometric and panoramic radiographs taken sequentially.


RESULTS
Angular changes of the infraorbital and nasal floor planes were not significant, showing that distraction osteogenesis starting after 5 years of age did not influence the maxillary skeletal base. Occlusal (plane) cant was reduced by 7 degrees on average following distraction osteogenesis, showing good dentoalveolar plasticity. Mandibular vertical changes showed a gradual return of the asymmetry, with growth in all patients (the ratio between affected and non-affected rami returned by 77% of the correction obtained by means of distraction 5 years postoperatively).


CONCLUSIONS
Although aesthetic and psychological advantages of distraction osteogenesis are well accepted it should only be applied after careful patient selection and honest explanation of the long-term recurrence by genetically determined craniofacial growth patterns.
Meazzini
Maria Costanza
MC
Department of Maxillo-Facial Surgery, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy. cmeazzini@yahoo.it
Mazzoleni
Fabio
F
Gabriele
Canzi
C
Bozzetti
Alberto
A
D002508:Cephalometry; D002675:Child, Preschool; D003766:Dental Occlusion; D004955:Esthetics, Dental; D005146:Facial Asymmetry / Q000145:classification / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008437:Maxilla / Q000473:pathology; D008445:Maxillofacial Development; D009296:Nasal Cavity / Q000473:pathology; D009915:Orbit / Q000473:pathology; D019857:Osteogenesis, Distraction; D011446:Prospective Studies; D011862:Radiography, Panoramic; D012008:Recurrence; D019291:Skull Base / Q000473:pathology; D014716:Vertical Dimension