Successful Costochondral Graft for Severe Hemifacial Microsomia in The Growing Mandible: A Case Report
Background. There are still controversies concerning the surgical management of severely hypoplastic mandible ramus in hemifacial microsomia in the growing child. Whether to perform mandible distraction or use bone graft to reconstruct the mandible, proceeded with or without orthognathic surgery. Case presentation. A 9-year-old boy complains of facial asymmetry and malocclusion since birth. He presented with left hemifacial microsomia and occlusal cant. The CT scan showed nearly absent left mandible ramus and undeveloped zygomatic arch. A costochondral graft was used to reconstruct the mandible ramus and zygomatic arch at nine years old, but two years after the operation it started to show major overgrowth and malocclusion. However, the significantly overgrown costal graft is considered quite exceptional, but can be perceived as an advantage for his next surgery. Conclusion. 2-year follow up after costochondral bone grafting to a growing mandible in hemifacial microsomia showed a remarkable growth which will facilitate orthognathic surgery at maturity.
Keywords - Costochondral Graft Overgrowth, Growing Mandible Reconstruction, Hemifacial Microsomia