Hemifacial Hypertrophy – Report of 2 Cases

Hemifacial hyperplasia (HH) is a rare congenital condition involving enlargement of one or more tissues of the face. The treatment is surgically challenging and requires expertise. This manuscript aims to report two similar appearing HH but warranting different surgical treatment. A 19?year?old female and a 14?year?old boy presented with right facial asymmetry since birth and sought correction of the same. Surgical treatment was planned. Based on clinical history, diagnosis and imaging, HH was diagnosed. The first case was entirely a soft tissue abnormality that was treated with debulking while the second case had involvement of facial bones, necessitating surgical recontouring. The facial asymmetry was addressed. Healing was uneventful. Though the aesthetical concern and appearance of the two cases of HH were same, the treatment vastly differed. This was based on the source of asymmetry. Proper diagnosis and informed decision are a key for successful surgical outcome.

Clinical and epidemiological profile of cleft lip/ palate deformities in Tamil Nadu, India

Background: Cleft lip and palate deformities are commonly detected at the time of birth in most of the developing countries like India. The surgical management of cleft lip/ palate deformities involve multi-disciplinary approach with corrective measures from dental surgeon, plastic surgeon, speech pathologist and audiologist. The role of pediatricians in clinical management of cleft lip is often missed. This study was done to evaluate the clinical profile of cleft lip and palate deformities.Methods: This cross sectional study was carried out among 1077 patients diagnosed with cleft lip or cleft palate deformity for a period of 5 years between 2014 and 2019. A structured patient information schedule was prepared and data regarding the age, gender, antenatal details and parental history were recorded. A detailed clinical examination was carried out to evaluate the presence of complete and incomplete deformity in the lip, alveolus, hard palate and soft palate.Results: Complete cleft lip was present in 47.8% of the participants on the left side while on the right, complete cleft lip was present in 29.4% of the participants. Complete deformity of the alveolus on the left side was present in 45.4% of the participants while complete deformity on the right side of alveolus was present in 27.4% of the participants.Conclusions: It is important the pediatricians sensitize the parents regarding the clinical and supportive management and also initiate the surgical correction of this deformity with help of a multidisciplinary team.

Craniofacial Deformity in a Patient with Dyke-Davidoff-Masson Syndrome: A Case Report

PURPOSE: The Dyke-Davidoff-Masson syndrome is a rare disease entity that was first reported in 1993, and it is characterized by not only the cerebral hemiatrophy that is accompanied by the ipsilateral ventriculomegaly and ipsilateral compensatory osseous hypertrophy, but also the overgrowth of the paranasal sinuses. No studies have attempted to examine it from perspectives of the skull deformity and plastic surgery. Here, we report our case with a review of the literatures. METHODS: A 45-year-old man with Dyke-Davidoff-Masson visited our medical institution with nasal bone fracture. Based on the previously taken brain MRI scans, we measured the degree of craniofacial deformity, and the horizontal distance, which is based on the margin of the skull, as well as the falx cerebri. RESULTS: We made a comparison of the degree of craniofacial deformity. This showed that the mean horizontal distance on the axial view was shorter by approximately 28.46%, as compared with that of the left unaffected side. CONCLUSION: The Dyke-Davidoff-Masson is characterized by a concurrent presence of the atrophy of the cerebral hemisphere, with the cranial deformity. For the reconstruction of the bone and soft-tissue deformity with Dyke-Davidoff-Masson syndrome, it is needed to perform objective assessments.

Craniofacial Deformity in a Patient with Dyke-Davidoff-Masson Syndrome: A Case Report

PURPOSE: The Dyke-Davidoff-Masson syndrome is a rare disease entity that was first reported in 1993, and it is characterized by not only the cerebral hemiatrophy that is accompanied by the ipsilateral ventriculomegaly and ipsilateral compensatory osseous hypertrophy, but also the overgrowth of the paranasal sinuses. No studies have attempted to examine it from perspectives of the skull deformity and plastic surgery. Here, we report our case with a review of the literatures. METHODS: A 45-year-old man with Dyke-Davidoff-Masson visited our medical institution with nasal bone fracture. Based on the previously taken brain MRI scans, we measured the degree of craniofacial deformity, and the horizontal distance, which is based on the margin of the skull, as well as the falx cerebri. RESULTS: We made a comparison of the degree of craniofacial deformity. This showed that the mean horizontal distance on the axial view was shorter by approximately 28.46%, as compared with that of the left unaffected side. CONCLUSION: The Dyke-Davidoff-Masson is characterized by a concurrent presence of the atrophy of the cerebral hemisphere, with the cranial deformity. For the reconstruction of the bone and soft-tissue deformity with Dyke-Davidoff-Masson syndrome, it is needed to perform objective assessments.

The reconstruction of posttraumatic craniofacial deformity using modified lefort II and III osteotomy and autogenous iliac bone graft

Cranial Cephalometric Measurement using Newly Devised Caliper and Computer Program

The measurement and visualization of the roundness of the cranial circumference has not been attempted by the simple measurement device. That's why there has been a tendency that the morphologic cranial deformity can be diagnosed with accuracy only by the experienced physician. The accurate understanding of the roundness of the cranial circumference, however, is essential for the diagnosis and the decision of the treatment principle in cranofacial morphological deformity. Current methods, such as simple physical examination and/or the photography, are not enough to accurately express the roundness of the cranial circumference. In order to develop the new method of measurement, authors selected 16 points from the axial cutting plane of the cranium. These points can be selected under the same principle even though the axial plane changes. After measuring the distance of 16 points, the values are put into computer program. In conclusion, authors can retrieve the x, y coordinates of the 16 points and can show the intuitive roundness of the circumference of the selected axial plane of the cranium. This measurement tool will be helpful not only for the identification of the severity of the morphologic cranial deformity, but for the classification and the assessment of the result of the surgery.

Establishment and application of craniofacial three-dimensional visualization model / 实用口腔医学杂志

Objective:To establish a three-dimensional visualization model of craniofacial hard and soft tissues with data based on CT. It could be used in clinic as diagnosis and operation simulation. Methods:Original data of patients' craniofacial hard and soft tissues by CT scanning was transferred into the system. After 2-D and 3-D image preprocessing, advanced Marching Cubes Algorithm (Marching Tetrahedron Algorithm) was used for surface fitting;3-D volume rendering was accomplished by footprint method. Results: The whole craniofacial frame and its surface could be observed clearly in reconstructed 3-D Model. Furthermore, the 3-D Model could be seen from any sight angle and sectioned in any direction and place. Doctors could observe the characters of craniofacial deformity for more details. Conclusion: The problems of X-ray reflection of metal brackets, control of X-ray dosage and time spending in 3-dimensional visualization model reconstruction were solved. This model could be used in clinic for diagnosis and operation simulation.