Murray J E, Kaban L B, Mulliken J B
Plast Reconstr Surg. 1984 Aug;74(2):186-99. doi: 10.1097/00006534-198408000-00003.
Our experience over the past 25 years leads us to conclude that hemifacial microsomia is a progressive skeletal and soft-tissue deformity with the earliest skeletal manifestations in the mandible. We find that not only does the mandibular asymmetry become worse with time, but as the contralateral side grows, the deformed mandible also increases ipsilateral secondary deformation of the maxilla, nose, and orbit. We also find that there is virtually no "catch up" growth on the affected side of the face and that these patients always become more deformed with age. The psychological problems also increase with time and progression of the facial deformity. Based on our experience with correction of end-stage deformities, we now treat these patients at the earliest possible age, as determined by the patient's skeletal classification. We treat the mandible first in the hope that this repositioning in a more physiologic position will unlock the growth potential of the adjacent structures, minimize secondary deformity, and improve function and appearance to the greater benefit of the skeletal and psychological growth of the patient.
我们过去25年的经验使我们得出结论，半侧颜面短小畸形是一种进行性骨骼和软组织畸形，最早的骨骼表现出现在下颌骨。我们发现，不仅下颌不对称会随着时间推移而加重，而且随着对侧生长，畸形的下颌骨还会增加同侧上颌骨、鼻子和眼眶的继发性变形。我们还发现，面部患侧几乎没有“追赶性”生长，并且这些患者总是随着年龄增长而变得更加畸形。心理问题也会随着面部畸形的发展而增加。基于我们矫正晚期畸形的经验，我们现在根据患者的骨骼分类，在尽可能早的年龄治疗这些患者。我们首先治疗下颌骨，希望这种在更生理位置的重新定位能够释放相邻结构的生长潜力，将继发性畸形降至最低，并改善功能和外观，从而对患者的骨骼和心理发育更有益处。
