Complex craniofacial diseases and deformities require complex, multistage treatment. One such complex disease that cause craniofacial tissue developmental disturbance is the Hemifacial Microsomia, where in the entire half of the mid-face and lower face is ill developed. This leads to improper facial growth, poor facial esthetics and functional compromise at a very younger age itself. The patient shown here in is a female in her early twenties whose parents were worried about her appearance. They had gone elsewhere and the case was mishandled with multiple surgeries, as seen in the 3D reconstruction and radiographs. The imaging showed a shortened mandible with poorly developed Tempromandibular joint. The case was managed by intra-oral distraction with no additional grafts. The advantage was that the entire surgery was done using an intra-oral approach that eliminated external scar. Secondly, no additional grafts were procured there by the secondary scar either at the rib region or the hip region was eliminated.
Through an intra-oral approach, a vestibular incision was made on the affected side. An osteotomy cut was made. The arms of the intra-oral distractor were adapted to the bone. The distractor was secured with screws and slowly distracted. The CT shows the distractor in position and gradual distraction causing lengthening of the mandible. In due course of time, the patient had better esthetic and functional efficiency.
Through an intra-oral approach, a vestibular incision was made on the affected side. An osteotomy cut was made. The arms of the intra-oral distractor were adapted to the bone. The distractor was secured with screws and slowly distracted. The CT shows the distractor in position and gradual distraction causing lengthening of the mandible. In due course of time, the patient had better esthetic and functional efficiency.
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