Growth after construction of the temporomandibular joint in children with hemifacial microsomia.

Free costochondral grafts have been used to construct the absent ascending ramus and condylar head of 22 children with hemifacial microsomia (HFM) who were less than 14 years of age. Evidence of continued growth was demonstrated in all patients. Growth was determined by measurement of cephalograms or by inference; if the patient grew extensively in height but his/her face remained symmetric, the graft was inferred to have grown. In two patients, considerable overgrowth occurred, displacing the chin to the opposite side and causing a class III malocclusion. Variations in age or type of adjunctive operations did not affect growth. There appears to be no single explanation for all findings. Because all of the grafts grew, early joint construction and correction of hemifacial microsomia are advocated.