Published online Jan 6, 2021. doi: 10.12998/wjcc.v9.i1.148
Peer-review started: February 16, 2020
First decision: September 29, 2020
Revised: October 12, 2020
Accepted: November 4, 2020
Article in press: November 4, 2020
Published online: January 6, 2021
Processing time: 319 Days and 13.9 Hours
Hemifacial microsomia (HFM) is the second most common craniofacial congenital anomaly following cleft lip and palate. Because of the various phenotypic spectra and the severity of the deformity, a wide range of treatment approaches have been proposed. Recently, the surgery-first approach (SFA) was introduced to treat mild to moderate HFM, and it yielded a balanced facial appearance. The SFA not only promotes rapid improvement in facial aesthetics but also considerably reduces the overall treatment time.
A female patient, aged 25 years old, sought orthodontic treatment with the chief complaint of dental and facial asymmetry. After a comprehensive physical examination and imaging analysis were performed, the patient was diagnosed with mild HFM that was primarily attributed to unilateral abnormal development of the maxilla-mandibular. The SFA was carried out to correct the skeletal deformity. The palatal suture was used as the midline of the maxilla in the surgical plan to center the maxilla, and the chin was also properly positioned to obtain a relatively symmetrical facial appearance. Four weeks after the surgery, the patient was referred for postsurgical orthodontics to decompensate the dentition and stabilize the occlusion. After 20 mo of treatment, all orthodontic appliances were removed. The posttreatment photographs of the patient and her smile confirmed good aesthetic and occlusal results.
Mild HFM can be corrected by SFA, which not only promotes rapid improvement in facial aesthetics but also considerably reduces the overall treatment time.
Core Tip: Hemifacial microsomia (HFM) is the second most common craniofacial congenital anomaly following cleft lip and palate. Recently, the surgery-first approach (SFA) was introduced to treat mild to moderate HFM, promote rapid improvement in facial aesthetics and reduce the overall treatment time. When presurgical orthodontics information on the underlying skeletal deformity is not available, careful treatment planning and strong collaborations between skilled orthodontists and surgeons are needed to predict accurately surgical skeletal movement and postsurgical tooth movement after SFA. This case report presents a successful SFA in a patient with mild HFM. The treatment outcome confirmed a balanced facial appearance.