Hemifacial hypertrophy: Exploring new avenues of treatment modalities

'Adaptable condylectomy' for acquired facial asymmetry and malocclusion caused by temporomandibular joint condylar hyperplasia

This article describes the 'adaptable condylectomy' and highlights two innovative treatment protocols for the variety of acquired facial asymmetry and associated malocclusion caused by condylar hyperplasia, as illustrated by the cases of seven patients presenting different manifestations of condylar hyperplasia. Protocol I (three cases) is applied for condylar hyperplasia with a normal occlusion and involves a high condylectomy, with the goal of guiding the mandible back to the original occlusion. Protocol II (four cases) is applied for condylar hyperplasia with diverse acquired malocclusions and involves condylectomy at a level adapted to the malocclusion, allowing the mandible to be guided back to the occlusion that pre-existed the active change caused by the condylar hyperplasia, or to a position as close to the midline as possible. Both protocols are followed by gradual self-correction of the acquired facial asymmetry. These protocols often obviate the need for further surgical intervention and, if further correction is needed, it is much simpler.

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.

True Hemifacial Hyperplasia-Clinical Presentations and Treatment Options

Congenital hemifacial hyperplasia (CHFH) is a rare congenital malformation characterized by marked unilateral overdevelopment of the hard and soft tissues of the head and face region. The exact etiology is not clear; it is usually evident at birth and increases with age, mostly till puberty. In some cases multiple systems are involved. Treatment is usually indicated in cases where esthetics is a concern. A 6 year old female reported to the Department of Oral Medicine and Radiology with the features of congenital hemifacial hyperplasia, we are making an attempt to present a rare case of CHFH in order to highlight the clinical manifestations and treatment options.