Clinical case

Correction of Hemifacial Microsomia

Correction of Hemifacial Microsomia

CASE REPORT

 

This 26-year-old male was diagnosed with right-sided hemifacial microsomia Pruzansky’s Type IIb. In this case the craniomaxillofacial surgeon decided to use 2 CADskills facial implants to correct the facial asymmetry, instead of the usual facial rotation using orthognathic procedures.

The surgeon contacted CADskills with his specific wishes and several questions that required our expertise. According to the treatment plan, a right-sided mandibular angle implant and a right-sided malar augmentation implant were required along with sliding genioplasty. 

Both implants were designed meticulously using the mirrored image of the unaffected side of the patient’s skull. For the mandibular implant, a two-piece design was proposed, with a puzzle connection and lips for screw fixation. The jaw implant was 3D printed in titanium alloy, allowing the integration of a scaffold at the bony surfaces. The surgeon preferred a malar component in PEEK (polyether ether keton). 

Our engineers made a virtual simulation of the genioplasty cut to anticipate implant placement. A cutting guide was delivered together with the implants. 

Pre- and postoperative cephalogram. The malar PEEK implant is not visible as it is radiolucent. Only the fixation screws show up in plain X-ray. 

The patient is very satisfied with the outcome and quoting the operator: “The dimensions of the patient specific implants were excellent. The outcomes are matching the simulation models“

The pictures show the result preoperatively (A & C) and 15 days postoperatively (B & D).

This picture shows the result approximately 6 months postoperatively. 

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