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半侧颜面短小畸形的多学科治疗:几例临床病例

Multidisciplinary Treatment of Hemifacial Microsomia: Several Clinical Cases.

作者信息

Cano-Rosás Mónica, Benito-Cano Juan, Benito-Cano Javier, Diosdado-Cano José María, Benito-Duque Pablo, Curto Adrián

机构信息

Department of Surgery, Faculty of Medicine, University of Salamanca, Alfonso X El Sabio Avenue s/n, 37007 Salamanca, Spain.

Private Practice, 28034 Madrid, Spain.

出版信息

Clin Pract. 2024 Nov 8;14(6):2410-2418. doi: 10.3390/clinpract14060188.

Abstract

Hemifacial microsomia is the second most common congenital anomaly of the craniofacial region. Hemifacial microsomia is characterised by unilateral hypoplasia of the ear. Treatment of this condition depends on the severity of the lesion. The treatment of hemifacial microsomia must be carried out by a multidisciplinary group of professionals familiar with this pathology, including plastic surgeons, parapsychologists, orthodontists, and paediatricians. In hemifacial microsomia, microtia is usually accompanied by alterations of the middle ear. Since the ear develops embryonically from the first and second branchial arches, the facial areas that also develop from these embryonic origins are usually affected to a greater or lesser degree, including through hypoplasia of the jaw, maxilla, zygomatic bones, and temporal bone, among others. Although jaw hypoplasia is the most evident deformity in craniofacial microsomia, microtia is the alteration that often has the greatest aesthetic impact on patients. Alterations in dentition are also common, typically presenting as a cephalad inclination of the anterior occlusal plane of the maxilla and mandible on the affected side. This study aims to review the surgical approach and evaluate the results of a paediatric case of hemifacial microsomia. Hemifacial microsomia is present at birth, and successful reconstruction is essential for the correct integration of such infantile patients into society. Multiple facial asymmetries as well as neonatal onset are a challenge for reconstructive surgery, and the importance of multidisciplinary treatment in these patients must be emphasised.

摘要

半侧颜面短小是颅面部第二常见的先天性畸形。半侧颜面短小的特征是耳部单侧发育不全。这种病症的治疗取决于病变的严重程度。半侧颜面短小的治疗必须由熟悉这种病症的多学科专业团队进行,包括整形外科医生、心理医生、正畸医生和儿科医生。在半侧颜面短小中,小耳畸形通常伴有中耳的改变。由于耳朵在胚胎期由第一和第二鳃弓发育而来,同样从这些胚胎起源发育的面部区域通常会受到不同程度的影响,包括颌骨、上颌骨、颧骨和颞骨等发育不全。虽然颌骨发育不全是颅面部短小畸形中最明显的畸形,但小耳畸形往往是对患者美学影响最大的改变。牙列改变也很常见,通常表现为患侧上颌和下颌前咬合平面向上倾斜。本研究旨在回顾手术方法并评估一例小儿半侧颜面短小病例的治疗结果。半侧颜面短小在出生时就存在,成功的重建对于这类婴儿患者正确融入社会至关重要。多种面部不对称以及新生儿期发病对重建手术来说是一项挑战,必须强调这些患者多学科治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9498/11587098/6f095b98357d/clinpract-14-00188-g001.jpg

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