Paper Title
Successful Costochondral Graft for Severe Hemifacial Microsomia in The Growing Mandible: A Case Report
Abstract
Background. There are still controversies concerning the surgical management of severely hypoplastic mandible
ramus in hemifacial microsomia in the growing child. Whether to perform mandible distraction or use bone graft to
reconstruct the mandible, proceeded with or without orthognathic surgery. Case presentation. A 9-year-old boy complains of
facial asymmetry and malocclusion since birth. He presented with left hemifacial microsomia and occlusal cant. The CT
scan showed nearly absent left mandible ramus and undeveloped zygomatic arch. A costochondral graft was used to
reconstruct the mandible ramus and zygomatic arch at nine years old, but two years after the operation it started to show
major overgrowth and malocclusion. However, the significantly overgrown costal graft is considered quite exceptional, but
can be perceived as an advantage for his next surgery. Conclusion. 2-year follow up after costochondral bone grafting to a
growing mandible in hemifacial microsomia showed a remarkable growth which will facilitate orthognathic surgery at
maturity.
Keywords - Costochondral Graft Overgrowth, Growing Mandible Reconstruction, Hemifacial Microsomia