Januari 11, 2017
>> so hemifacial microsomia, which is alsoknown as craniofacial microsomia, or first and second branchial arch syndrome, is thesecond most common condition of the head and neck in children, after cleft lip and palate. we don’t know what causes it, but what happensis an underdevelopment of one side of the face. and up to 20% of the patients, thiscan be both sides of the face. we have varying deficiencies of the soft tissue and bone,which can include the ear, the lower jaw, the upper jaw, the soft tissue and the nervousstructure. and it varies from being very mild to even almost complete absence of thosestructures. so hemifacial microsomia is typically diagnosedat birth. so the treatment of hemifacial microsomia
depends on the degree of the difference, aswell as the age of the child. in children that have less severe deformities, frequentlyit’s a matter of just taking the existing bone structure and cutting it and shiftingit, or elongating it. or doing a procedure called distraction where we actually cut thebone, pull it apart, and create new bone. and then we do things to the soft tissue likeadding soft tissue from elsewhere, such as fat grafts and fat transfers. all of whichare done to normalize the appearance and improve the facial symmetry. in some children that have a very severe manifestationof the disease, such as an absence of the bone of the jaw, or an absence of the ear,then we have to rebuild that. and we do that
with bone grafts taken from the rib or fromthe lower leg to build the jaw. and to rebuild the ear, taking cartilage from the rib tocarve a new ear. one of the things that we’ve worked on recently,when some of these children are born with a severe deformity, is to use surgical planningusing 3d images that we take of the children. we can actually manipulate them with the computer,so that we get a virtual image ahead of time of what the child is going to look like andwhat we can do, and what we should do, to add to make that deficient mandible, or jaw,the most normal. so children with hemifacial microsomia, acertain of them may have an increase incident of associated anomalies such as cardiac condition,spine condition, limb condition. so we work
close with orthopedic, with cardiology, withcardiac surgery, hand surgery, to address all of those needs concurrently. some of thechildren that are more severely effected with hemifacial microsomia may require respiratorysupport. they may not be able to breathe at birth, and sometimes during childhood, becausethe lower jaw structure that supports the breathing apparatus, such as the tongue, isnot fully developed. we work closely with our neonatologist aswell as our neonatal craniofacial program to make sure, and our neonatal airway program,to make sure that those children get the respiratory support they need. every patient is individual,and our team will develop an individual treatment plan to address every one of the major areasof deficiency or deformity in hemifacial microsomia
with the best possible outcome.
Tidak ada komentar
Posting Komentar