[Sagittal split ramus osteotomy combined with intraoral distraction osteogenesis for hemifacial microsomia].

Abstract

Objective: To investigate the effect of sagittal split ramus osteotomy(SSRO) combined with distraction osteogenesis(DO) for hemifacial microsomia (HFM).

Methods: From January 2013 to September 2015,7 cases of unilateral HFM were included in the study. The 3-dimensional reconstruction images were used for the operation design. The location of the germs and inferior alveolar nerve was marked to avoid injury. The distractor was fixed after SSRO. The distractor was distracted 2-4 mm intraoperatively and began enlongation 3-5 days after operation,1-2 mm every day until the pre-designed length attained. The patients were followed up for 3-D CT and measurement of the height of bilateral ramus.

Results: The enlongation length was 7 mm to 20 mm(mean,14.6 mm).The facial symmetry and occlusion plane was improved a lot. No complication occurred. The mean follow-up period was 22 months (range 17-32 months) with almost symmetrical appearance and occlusion function.

Conclusions: SSRO combined with DO has a good therapeutic effect and low complication for patients with HFM. The distraction rate is relatively high with a short treatment period. The ramus width, even thickness, are not decreased, or even can be increased after DO.