title: Bimaxillary Orthognathic Approach to Correct Skeletal Facial Asymmetry of Hemifacial Microsomia in Adults.
abstract: BACKGROUND
  Hemifacial microsomia (HFM) is the second most common congenital craniofacial deformity after cleft lip and palate. Distraction osteogenesis (DO) is regarded as an alternative and efficient treatment option for patients with HFM. However, DO was not proven effective for all cases, and the results of long-term follow-up were not satisfactory as expected. Compared with DO, the orthognathic surgery approach may offer more stable clinical outcomes for this kind of disease. The purpose of this study is to evaluate the long-term clinical and radiographic outcome of bimaxillary orthognathic surgery in the treatment of adult HFM.
  
  
  METHODS
  Eight patients with HFM who had undergone bimaxillary orthognathic surgery between 2008 and 2012 were included in the study. The surgical procedures included Le Fort I osteotomy, inverted-L osteotomy, sagittal split ramus osteotomy, genioplasty, and iliac bone grafting. Pre- and postoperative orthodontic treatments were performed, respectively. Clinical and radiographic examinations were carried out to assess postoperative outcomes.
  
  
  RESULTS
  No obvious complications appeared postoperatively and no recurrences occurred during follow-up. All patients obtained satisfactory aesthetic results. Marked improvement in facial contour and occlusion were observed. Plain radiographs showed that the height ratios between the affected and unaffected ramus were ameliorated significantly.
  
  
  CONCLUSIONS
  The bimaxillary orthognathic approach to correct the deformity of adult HFM can obtain stable results in the long-term follow-up, and should be considered as a priority method for the treatment of adult patients with dentofacial deformity.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: West China Hospital of Stomatology, State Key Laboratory of Oral Disease, Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: En
authors.initials: E
authors.lastname: Luo
authors.affiliation: West China Hospital of Stomatology, State Key Laboratory of Oral Disease, Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: Shimao
authors.initials: S
authors.lastname: Yang
authors.affiliation: West China Hospital of Stomatology, State Key Laboratory of Oral Disease, Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: Wen
authors.initials: W
authors.lastname: Du
authors.affiliation: West China Hospital of Stomatology, State Key Laboratory of Oral Disease, Sichuan University, Chengdu, 610041, People's Republic of China.
authors.forename: Qianming
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Stomotology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, 610072, People's Republic of China.
authors.forename: Chuhang
authors.initials: C
authors.lastname: Liao
authors.affiliation: Department of Stomotology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, 610072, People's Republic of China. fwross10@sina.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Fei
authors.affiliation: West China Hospital of Stomatology, State Key Laboratory of Oral Disease, Sichuan University, Chengdu, 610041, People's Republic of China. drhu-vip@sohu.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Hu
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D003198:Computer Simulation; D004954:Esthetics; D005146:Facial Asymmetry / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D063172:Genioplasty / Q000379:methods; D006053:Goldenhar Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D019857:Osteogenesis, Distraction / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D012494:Sampling Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Distraction osteogenesis; Facial asymmetry; Hemifacial microsomia; Orthognathic surgery