TY - JOUR
T1 - True hemifacial microsomia and hemimandibular hypoplasia with condylar-coronoid collapse
T2 - Diagnostic and prognostic differences
AU - Meazzini, Maria C.
AU - Brusati, Roberto
AU - Caprioglio, Alberto
AU - Diner, Patrik
AU - Garattini, Giovanna
AU - Giannì, Ennio
AU - Lalatta, Faustina
AU - Poggio, Carlo
AU - Sesenna, Enrico
AU - Silvestri, Alessandro
AU - Tomat, Catherine
PY - 2011/5
Y1 - 2011/5
N2 - Introduction: Long-term results after orthopedic or surgical treatment of hemifacial microsomia (HFM) have shown a tendency toward recurrence of the facial asymmetry. However, the literature contains a number of successful case reports that show surprising changes in the morphology of the condyles. In addition, patients with similar mandibular asymmetries, treated early with surgery, have excellent long-term follow-ups, especially those who have little or no soft-tissue involvement, but only severe mandibular ramal deformities. The phenotypes of these cases are unexpectedly similar, with a consistent collapse of the condyle against the coronoid and a deep sigmoid notch. The objectives of this article were to help distinguish true HFM from this peculiar type of hemimandibular asymmetry morphologically and to quantify their differences before treatement and in the long term. Methods: Panoramic radiographs taken at pretreatment and the long-term follow-up of 9 patients with hemimandibular hypoplasia, characterized by the collapse of the condyle against the coronoid, were compared with those of 8 patients with severe type I and type II HFM; these records were collected before and at least 10 years after distraction osteogenesis. Results: Ratios and angular measurements before and after treatment differed significantly between the 2 groups. Conclusions: Perhaps these patients were misdiagnosed and actually had secondary injuries of the condyle, which have a normal functional matrix. Therefore, with growth and functional stimulation, they would tend to grow toward the original symmetry. To make a differential diagnosis between true HFM and this peculiar type of hemimandibular hypoplasia, the collaboration between not only orthodontists and surgeons, but also geneticists and dysmorphologists, is of great importance because of the different prognoses.
AB - Introduction: Long-term results after orthopedic or surgical treatment of hemifacial microsomia (HFM) have shown a tendency toward recurrence of the facial asymmetry. However, the literature contains a number of successful case reports that show surprising changes in the morphology of the condyles. In addition, patients with similar mandibular asymmetries, treated early with surgery, have excellent long-term follow-ups, especially those who have little or no soft-tissue involvement, but only severe mandibular ramal deformities. The phenotypes of these cases are unexpectedly similar, with a consistent collapse of the condyle against the coronoid and a deep sigmoid notch. The objectives of this article were to help distinguish true HFM from this peculiar type of hemimandibular asymmetry morphologically and to quantify their differences before treatement and in the long term. Methods: Panoramic radiographs taken at pretreatment and the long-term follow-up of 9 patients with hemimandibular hypoplasia, characterized by the collapse of the condyle against the coronoid, were compared with those of 8 patients with severe type I and type II HFM; these records were collected before and at least 10 years after distraction osteogenesis. Results: Ratios and angular measurements before and after treatment differed significantly between the 2 groups. Conclusions: Perhaps these patients were misdiagnosed and actually had secondary injuries of the condyle, which have a normal functional matrix. Therefore, with growth and functional stimulation, they would tend to grow toward the original symmetry. To make a differential diagnosis between true HFM and this peculiar type of hemimandibular hypoplasia, the collaboration between not only orthodontists and surgeons, but also geneticists and dysmorphologists, is of great importance because of the different prognoses.
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U2 - 10.1016/j.ajodo.2010.01.034
DO - 10.1016/j.ajodo.2010.01.034
M3 - Article
C2 - 21536185
AN - SCOPUS:79955618796
VL - 139
JO - American Journal of Orthodontics and Dentofacial Orthopedics
JF - American Journal of Orthodontics and Dentofacial Orthopedics
SN - 0889-5406
IS - 5
ER -