Orthopedically induced condylar growth in a patient with hemifacial microsomia.

OBJECTIVE

Hemifacial microsomia is a congenital abnormality that causes three-dimensional facial asymmetry, affection of the dental occlusion, and failure of growth of the midface in the growing child. This report outlines orthopedically induced condylar growth in a patient with hemifacial microsomia.

PATIENT

A 7-year-old girl with hemifacial microsomia, complete absence of the left mandibular condyle, and severe facial asymmetry was treated orthopedically in an early stage by means of a functional appliance. Functional therapy was instituted to stretch the deficient soft tissues to guide and promote skeletal growth and stimulate the affected areas. The treatment was completed with fixed appliances.

RESULTS

The effect of the therapy was an excessive change in condylar growth in the affected side. Facial asymmetry was corrected and a symmetric mouth opening was established.

CONCLUSIONS

The treatment of patients with hemifacial microsomia should be initiated early enough so that the stimulus could in some degree normalize the deficient tissues and induce bone apposition, and in some cases surgical intervention could be avoided.