title: Combined Bimaxillary Distraction Osteogenesis Associated with Orthognathic Surgery for Hemifacial Microsomia in Adults.
abstract: BACKGROUND
  Hemifacial microsomia (HFM) is one of the most common congenital craniofacial asymmetries. Distraction osteogenesis (DO) is always recommended as an effective option for the treatment of HFM, but some studies showed that the asymmetry remained after DO. In comparison with DO, stable clinical outcomes could be achieved by orthognathic surgery approach as well. However, soft tissue expansion cannot be performed. In this study, we aim to assess the radiographic and clinical results of bimaxillary DO associated with staged orthognathic surgery in the treatment of craniofacial asymmetry for adult HFM patients.
  
  
  METHODS
  Twelve HFM patients who had been treated with bimaxillary DO and secondary orthognathic surgery between 2006 and 2013 were included in this study. Bimaxillary DO and staged orthognathic surgery were performed according to the particular condition. Clinical and cephalometric photographs were carried out pre- and postoperatively to evaluate the outcomes.
  
  
  RESULTS
  No significant complications occurred postoperatively. Excellent cosmetic outcomes such as notable improvement in facial pattern and occlusion were achieved. Cephalometrically, the height ratios of the affected/unaffected ramus were improved by 23.81% on average, and the photographic analysis demonstrated a rotation of the chin point toward the mid-line. Moreover, the occlusal cant was corrected from the slant to level by 8.95° on average.
  
  
  CONCLUSIONS
  The application of bimaxillary DO associated with staged orthognathic surgery in correcting the asymmetry of adult patients with HFM could have satisfactory aesthetic results, and it should be considered an alternative option for these patients.
  
  
  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 Diseases, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China.
authors.forename: Hanghang
authors.initials: H
authors.lastname: Liu
authors.affiliation: West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Zhang
authors.affiliation: West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.affiliation: West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China.
authors.forename: Qianming
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Guangzhou Hospital of Integrated Traditional and Western Medicine, Guangzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Shao
authors.affiliation: West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China. luoen521125@sina.com.
authors.forename: En
authors.initials: E
authors.lastname: Luo
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006053:Goldenhar Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D019857:Osteogenesis, Distraction / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011862:Radiography, Panoramic / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Distraction osteogenesis; Facial asymmetry; Hemifacial microsomia; Orthognathic surgery