Craniofacial Microsomia: A Long-term Outcome of Early Mandibular Distraction Osteogenesis and Comprehensive Care at the Tawanchai Center
Bowornsilp Chowchuen BSc, MD, MBA*, Poonsak Pisek DDS**, Prathana Chowchuen MD***, Ampornpan Theeranut PhD****
Affiliation : * Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ** Department of Orthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand *** Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ****Department of Adult Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
Background : Craniofacial microsomia (CFM) is a complex, congenital, malformation, primarily involving structures
derived from the first and second branchial arches. There is limited information on its long-term management and outcomes.
Objective : To present the long-term management and outcome of a patient with CFM treated by early distraction osteogenesis
and a protocol of comprehensive care at the Tawanchai Center, Srinagarind Hospital, Khon Kaen University.
Material and Method: After reviewing the medical records for the clinical presentations, assessments, and long-term
managements and outcomes of patients with CFM at Srinagarind Hospital, we focused on one patient, treated by early
surgical reconstruction, mandibular distraction osteogenesis (DO), and comprehensive care according to the protocol
developed at the Tawanchai Center.
Results : The patient presented normal speech, mouth breathing, normal swallowing, and normal temporomandibular joint
function. He had an antimongoloid slant, left malar hypoplasia, a cross bite, occlusal plane canting and a slightly deviated
chin to the right, a good mouth opening, and a normal bite pattern. The patient was completely satisfied according to overall
satisfaction, nose, and upper lip; and moderately satisfied according to overall face, head shape, and occlusion.
Conclusion : Our study suggests that the use of DO in young children with CFM provides good long-term distraction on the
growth of the mandible and greater facial symmetry. The study addresses the comprehensive evaluation of the long-term,
interdisciplinary, comprehensive care of a patient with CMS. Consideration of the needs and expectations of the patient and
his/her family and other involved stakeholders is essential.
Keywords : Craniofacial microsomia, Early mandibular distraction osteogenesis, Comprehensive management, Long-term outcome
