Abstract
Hemifacial microsomia (HFM) is a congenital disorder derived from hypoplasia of the first and second branchial arches that occurs at an incidence in the range of 1 in 3,000 to 5,000 births.
We reported a case of HFM with difficulty in management. The patient, when 9 years old, was treated with distraction osteogenesis in the left mandibular ramus to prevent progression of facial asymmetry. Although facial asymmetry was improved transiently just after early mandibular distraction, mandibular asymmetry with malocclusion was exacerbated due to unharmonious growth of the mandible a few years later. When the patient was 22 years old, sagittal split ramus osteotomy was performed to correct malocclusion after the cessation of mandibular growth. One year later, mandibular angle augmentation was undertaken to improve the asymmetric facial contour using custom-made artificial bone. Computed tomography taken after 2 years of augmentation showed good adaptation as well as bony union between the artificial bone and the mandible. The patient is satisfied with the stable occlusion and better facial contour.
