An Overview of Treatment and Recommendations for the Craniofacial Microsomia Patient

Craniofacial microsomia, or hemifacial microsomia, is characterized by a variety of craniomaxillofacial deformities including involvement of the mandible, dentition and occlusion, orbits, ears, muscles, nerves, and soft tissues of the head and neck region with secondary psychosocial and behavioral issues, as well as disturbances in speech, breathing, and sleep impairment. A variety of treatment options exist with personal surgeon preferences and experiences, but ideal treatment recommendations and sequencing should be determined in an interdisciplinary fashion, based upon individual patient characteristics, and not limited by biases. In general, management may involve ear tag removal and reconstruction, oral cavity (macrostomia) correction, orbital correction, functional appliance therapy, costochondral grafting or alloplastic total temporomandibular joint (TMJ) replacement, orthognathic surgery, distraction osteogenesis, and hard and soft tissue augmentation (autogenous or alloplastic). This chapter will review the available evidence and provide summarized recommendations regarding management options for craniofacial microsomia.