Huh Joonyoung, Park Ji-Song, Sodnom-Ish Buyanbileg, Yang Hoon Joo
Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea.
Maxillofac Plast Reconstr Surg. 2024 May 11;46(1):18. doi: 10.1186/s40902-024-00427-8.
Hemifacial microsomia is characterized by the hypoplasia of the mandible and temporomandibular joint, involving a variety of abnormalities of the craniofacial area. Since it gradually worsens as patients grow, it is necessary to understand the characteristics of facial bone growth and facial deformity in hemifacial microsomia patients in order to determine appropriate treatment timing and treatment methods.
Appropriate classification of hemifacial microsomia would facilitate accurate diagnosis, selection of treatment methods, and prognosis prediction. Therefore, in this article, we review previously published hemifacial microsomia classification and provide an overview of the growth of the facial skeleton and the characteristics of hemifacial microsomia-related facial deformities. The OMENS system is the most comprehensive classification method based on the characteristics of hemifacial microsomia deformity, but it needs to be improved to include malar/midface abnormalities and nerve involvement. In hemifacial microsomia, growth is progressing on the affected side, but to a lesser degree than the unaffected side. Therefore, surgical intervention in growing patients should be performed selectively according to the severity of deformity.
Understanding growth patterns is important to develop appropriate treatment protocols for correcting asymmetry in adult patients and to minimize secondary anomalies in growing patients.
半侧颜面短小畸形的特征为下颌骨和颞下颌关节发育不全，涉及颅面部区域的多种异常。由于其会随着患者生长而逐渐加重，因此有必要了解半侧颜面短小畸形患者面部骨骼生长及面部畸形的特征，以便确定合适的治疗时机和治疗方法。
对半侧颜面短小畸形进行恰当分类有助于准确诊断、治疗方法的选择及预后预测。因此，在本文中，我们回顾了既往发表的半侧颜面短小畸形分类，并概述了面部骨骼的生长以及半侧颜面短小畸形相关面部畸形的特征。OMENS系统是基于半侧颜面短小畸形畸形特征的最全面的分类方法，但需要改进以纳入颧骨/中面部异常和神经受累情况。在半侧颜面短小畸形中，患侧有生长，但程度低于健侧。因此，对于生长发育期患者的手术干预应根据畸形严重程度进行选择性实施。
了解生长模式对于制定合适的治疗方案以纠正成年患者的不对称以及尽量减少生长发育期患者的继发畸形非常重要。
