Correction of progressive hemifacial atrophy by orthognathic surgical procedures combined distraction osteogenesis and scapular flap transplantation: 5 cases report

Abstract

OBJECTIVE: To evaluate the feasibility and the therapeutic effect of orthognathic surgical procedures combined distraction osteogenesis and scapular flap for correction of progressive hemifacial atrophy. METHODS: 5 cases with progressive hemifacial atrophy were treated. 1 mild case was treated with microsurgical de-epithelia scapular flap (MDSF) and genioplasty in one stage. The 2 moderate cases were treated with Le Fort 1 osteotomy following by sagittal split ramus osteotomy and genioplasty at the first stage. 3 - 6 months later, the MDSFs were used for augmentation. 2 sever cases were treated with bimaxillary distraction osteogenesis on the affected side. 3 - 4 months later, the distraction devices were removed and MDSFs were transplanted. RESULTS: The facial asymmetry was obviously improved. The orthognathic procedures and distraction osteogenesis achieved good therapeutic effect. All the MDSFs were survived. CONCLUSIONS: The progressive hemifacial atrophy can result in very severe deformity when it occurs in very young age. The combined deformity of bone and soft tissue can be effectively corrected by orthognathic procedures combined with distraction osteogenesis and scapular flap transplantation.