Hemifacial microsomia.

Hemifacial microsomia is variable with respect to the degree of the deformity it presents, thus, treatment varies. Mild degrees of the condition are usually treated adequately by waiting until adolescence, when definitive surgical correction of any skeletal or soft tissue asymmetry can be dealt with. Some mild and moderate cases may benefit from orthodontic functional appliance therapy during growth, but orthodontic opinion is divided on the value of such therapy. Children with severe forms of hemifacial microsomia are improved in appearance during their school years by early surgery performed in the preschool period. A number of surgical approaches have been used at this stage. The technique currently being used by the author involves composite transfer of vascularized soft tissue for contouring, together with a vascularized costochondral strut to lengthen the affected side of the mandible. Early results using this method are satisfactory, but further work is required to assess the advantages of this over other techniques.