Hypoplasia-Hyperplasia

ע"
שת/
תבט/
ד"
י•
21•
Vertical Distraction
Costochondral rib grafts, Le Fort I Osteotomy
Sagittal split contralateral ramus & genioplasty
A: The skeletal deformity in unilateral
(left) craniofacial microsomia. Note the
absent ramus with deviation of the chin to
the affected side and an occlusal cant
upward toward the left side. The arrows
designate the proposed skeletal movements
of the mandible and maxilla. The dots
designate the midpoints of the upper face,
midface and chin. The dotted area
represents the area where bone is removed
from the maxilla and the interrupted lines
designate the proposed maxillary and chin
osteotomy sites. (Modified from Munro, I.
R., Lauritzen C. G. Classification and
treatment of hemifacial microsomia. In:
Caronni, E. P., (ed.). Craniofacial Surgery.
Boston: Little, Brown & Co., 391–400,
1985.)
B: At the completion of the
osteotomies with plate and screw
fixation applied. Note that the dots
have recreated the midsagittal
plane of the craniofacial skeleton.
The ramus has been reconstructed
with costochondral rib grafts. The
Le Fort I segment has been
impacted on the right side and a
bone graft has been inserted on the
left side. The sagittal split
osteotomy has been fixated with
screws and the genioplasty has
been secured with lag screws.