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Craniofacial Anomalies Associated with Microtia: Importance of Its Repair Before, During and After Ear Reconstruction

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Ear Reconstruction

Abstract

Distraction osteogenesis is a useful technique for correction of asymmetrical facial structures such as elongation of the mandible and maxillary. When facial bones are undeveloped in association with digenesis of the auricles, it represents even more complex congenital anomalies that require treatment. Distraction osteogenesis may be performed before, during, and after ear reconstruction. When the mandible is elongated alone it improves the soft tissue volume, and necessary it is possible to perform another distraction procedure in the future.

When mandible distraction is realized at the time of ear reconstruction, it could occur before spurt, with mandibular elongation and the possibility of other distraction procedures, or after spurt, with maxillary mandibular distraction. The advantage of performing both procedures at the same time is interesting to the patient and surgical team.

Distraction osteogenesis could be realized after ear reconstruction and follow the philosophy when it is realized during ear reconstruction.

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References

  • Amaral CMR, Buzzo CL, Rinco T et al (2001) Long-term follow-up of craniosynostosis treatment by gradual bone distraction. Braz J Craniofac Surg 4(1):7–12

    Google Scholar 

  • Avelar JM (1977) Reconstrução total do pavilhão auricular num tempo único cirúrgico. Rev Bras Cir 67:139–146

    Google Scholar 

  • Avelar JM, Psillakis JM (1981a) The use of galea flaps in craniofacial deformities. Ann Plast Surg 6:464

    Article  PubMed  CAS  Google Scholar 

  • Avelar JM, Psillakis JM (1981b) Microtia: total reconstruction of the auricle in one single operation. Br J Plast Surg 34:224

    Article  PubMed  CAS  Google Scholar 

  • Avelar JM, Vaccari MP, Barbosa ALM (2011a) Reconstrução da orelha traumática e congênita. In: Melega JM, Viterbo F, Mendes FH (eds) Cirurgia Plástica, os princípios e a atualidades. Guanabara Koogan, Rio de Janeiro

    Google Scholar 

  • Avelar JM, Barbosa ALM, Vaccari M (2011b) Deformidades congênitas da orelha – microtia. In: Carreirão S (ed) Cirurgia plástica para formação do especialista. Atheneu, Rio de Janeiro

    Google Scholar 

  • Berry GA (1889) Note on a congenital defect (colobomaa) of the lower lid. Roy Lond Ophth Hosp Rep 12(3):225–357

    Google Scholar 

  • Canton E (1861) Arrest of development of the left perpendicular ramus of the lower jaw, combined with the malformation of the external ear. Trans Path Soc London 12:237–241

    Google Scholar 

  • Cohen SR, Simms C, Burstein FD (1998) Mandibular distraction osteogenesis in the treatment of upper airway obstruction in children with craniofacial deformities. Plast Reconstr Surg 101(2):312–318

    Article  PubMed  CAS  Google Scholar 

  • Cohen SR, Simms C, Burstein FD (1999) Alternatives to tracheostomy in infants and children with obstructive sleep apnea. J Pediatr Surg 34(1):182–186

    Article  PubMed  CAS  Google Scholar 

  • Converse JM, McCarthy JG, Wood-Smith D (1979) Symposium on diagnosis and treatment of craniofacial anomalies. Mosby Co, St. Louis

    Google Scholar 

  • Franceschetti A, Klein D (1949) The mandibulofacial dysostosis a new hereditary syndrome. Acta Ophthalmol 27:143–224

    CAS  Google Scholar 

  • Goldenhar M (1952) Association malformatives de i’oeil et de i’oreille, en particulier le syndrome dermoids epibulbaire – appendices auriculiaire – fistula auris congenita et ses relations avec la dysostose mandibulo faciale. J Pediatr 63:991–999

    Google Scholar 

  • Goodman RM, Gorlin RJ (1977) Atlas of the face in genetic disorders. Mosby, Saint Louis

    Google Scholar 

  • Gorlin RJ, Jue KL, Jacobsen U et al (1963) Oculo – auriculo vertebral dysplasia. J Pediatr 63:991–999

    Article  PubMed  CAS  Google Scholar 

  • Guerrero RV, Guerrero AS, Gomes PRM (2011) Distrações osteogênicas craniofaciais. In: Melega JM, Viterbo F, Mendes FH (eds) Cirurgia Plástica, os princípios e a atualidades. Guanabara Koogan, Rio de Janeiro

    Google Scholar 

  • Hollier LH, Kim JH, Grayson B et al (1999) Mandibular growth after distraction in patients under 48 months of age. Plast Reconstr Surg 103(5):1361–1370

    PubMed  CAS  Google Scholar 

  • Horgan JE, Padwa BL, La Brie RA et al (1995) OMENS – plus: analysis of craniofacial and extracraniofacial anomalies in hemifacial microsomia. Cleft Palate Craniofac J 32:405–409

    Article  PubMed  CAS  Google Scholar 

  • Ilizarov GA, Soybelman LM, Chirkova AM (1970) Some roentgenographic and morphologic data on bone tissue regeneration in distraction epiphyscolysis in experiment. Ortop Traumatol Protez 31:26–36

    CAS  Google Scholar 

  • Jackson IT (1981) Reconstruction of the lower eyelid defect in treacher – Collins syndrome. Plast Reconstr Surg 67(3):365–367

    Article  PubMed  CAS  Google Scholar 

  • Jones NC, Farlie PG, Minichiello J et al (1999) Detection of an appropriate kinase activity in branchial arches I and II that coincides with peak expression of the Treacher Collins syndrome gene product, treacle. Hum Mol Genet 8(12):2239–2245

    Article  PubMed  CAS  Google Scholar 

  • Kerns GJ, Padwa BL, Mulliken JB et al (2000) Progresion of hemifacial asymmetry in hemifacial microsomia. Plast Reconstr Surg 105(2):492–498

    Article  Google Scholar 

  • Kochutina LN (1990) Regenerative myogenesis of the leg muscles during experimental lengthening. Izv Akad Nauk SSSR Biol 4:565–570

    PubMed  Google Scholar 

  • Lopes LD, Gonzalez NZT (2000) Anomalias orofaciales. In: Lopes LDY, Gonzalez NZT (eds) Logopedia y ortopedia maxilar en la rehabilitación orofacial. Masson, Barcelona

    Google Scholar 

  • Lopes LD, Andrade EMF, Vaccari-Mazzetti MP et al (2003) Anomalías cráneo- faciales. In: Jankielewicz I (ed) Prótesis buco-maxilo-facial. Quintessence, Barcelona

    Google Scholar 

  • Marsh KL, Dixon J, Dixon MJ (1998) Mutations in the Treacher-Collins Syndrome gene lead to mislocalization of the nucleolar protein treacle. Human Mol Genet 7(11):1795–1800

    Article  CAS  Google Scholar 

  • McCarthy JG (1999) Distraction of the craniofacial skeleton. Springer, New York

    Book  Google Scholar 

  • McCarthy JG (2002) The first decade of mandibular distraction: lessons we have learned. Plast Reconstr Surg 110(7):1704–1713

    Article  PubMed  Google Scholar 

  • McCarthy JG, Cutting CB, Shaw WW (1987) Vascularized calvarian flaps. Clin Plast Surg 14(1):37–47

    PubMed  CAS  Google Scholar 

  • McCarthy JG, Schreiber J, Karp N (1992) Lengthening the human mandible by gradual distraction. Plast Reconstr Surg 89:1–12

    PubMed  CAS  Google Scholar 

  • Meurmann Y (1957) Congenital microtia and meatal atresia. Arch Otolaryngol 66:443–449

    Article  Google Scholar 

  • Michiele S, Minotti B (1977) Lengthening of mandibular body by gradual surgical orthodontic distraction. J Oral Surg 35:187–192

    Google Scholar 

  • Molina F, Ortiz-Monastério F (1995) Mandibular elongation and remodelling by distraction: a farewell to major oeteotomies. Plast Reconstr Surg 96:825–840

    Article  PubMed  CAS  Google Scholar 

  • Molina F, Ortiz-Monastério F, Aguilar MPA et al (1998) Maxillary distraction: aesthetic and functional benefits in cleft lip- palate and prognathic patients during mixed dentition. Plast Reconstr Surg 101(4):951–963

    Article  PubMed  CAS  Google Scholar 

  • Morovic CG, Monastério L (2000) Distraction osteogenesis for obstructive apneas in patients with congenital craniofacial malformations. Plast Reconstr Surg 105(7):2324–2330

    Article  PubMed  CAS  Google Scholar 

  • Mulliken JB, Kaban LB (1987) Analysis and treatment of hemifacial microsomia in childhood. Clin Plast Surg 14(1):91–100

    PubMed  CAS  Google Scholar 

  • Munro IR (1980) One- stage reconstruction of the temporomandibular joint in hemifacial microsomia. Plast Reconstr Surg 66:699–704

    Article  PubMed  CAS  Google Scholar 

  • Munro IR, Lauritzen CG (1985) Classification and treatment of hemifacial microsomia. In: Caronni EP (ed) Craniofacial surgery. Little, Brown, Boston

    Google Scholar 

  • Ortiz-Monastério F, Molina F (1997) Simultaneous mandibular and maxilary distraction in hemifacial microsomia in adults: avoiding occlusal disasters. Plast Reconstr Surg 100:852–862

    Article  PubMed  Google Scholar 

  • Pruzansky S (1969) Not all dwarfed mandibles are alike. Birth Defects 5(2):120–129

    Google Scholar 

  • Raulo Y, Tessier P (1981) Mandibulo-facial dysostosis. Scand J Plast Reconstr Surg 15:251–256

    Article  PubMed  CAS  Google Scholar 

  • Rollnick BR, Kaye CI, Nagatoshi K et al (1987) Oculoauriculovertebral dysplasia and variants: phenotypic characteristics of 249 patients. Am J Med Genet 26:361–375

    Article  PubMed  CAS  Google Scholar 

  • Snyder CC, Levine GA, Swanson HM et al (1973) Mandibular lengthening by gradual distraction. Plast Reconstr Surg 51(5):506–508

    Article  PubMed  CAS  Google Scholar 

  • Souza LCM (1998) Microsomia hemifacial, síndrome de treacher – collins e anomalia de pierre-robin. In: Souza LCM, Silveira ME, Cappellette M et al (eds) Cirurgia ortognática e ortodontia. Santos, São Paulo

    Google Scholar 

  • Tessier P (1976) Anatomical classification of facial, cranio-facial and latero-facial clefts. J Maxillofac Surg 4:69

    Article  PubMed  CAS  Google Scholar 

  • Treacher-Collins E (1900) Cases with symmetrical congenital notches in outer part of each lower lid and defective development of malar bones. Trans Ophthalmol Soc 20:190–192

    Google Scholar 

  • Vaccari-Mazzetti MP (2005) Embriologia e crescimento da face. In: Carreirão S, Cardin VL, Goldenberg D (eds) Cirurgia Plástica – Sociedade Brasileira de Cirurgia Plástica. Ateneu, São Paulo

    Google Scholar 

  • Vaccari-Mazzetti MP, Molina F, Garcilazo M (1998) Facial growth in mandible elongation in hemifacial microsomia. Rev Bras Cir Craniofac 1:12–15

    Google Scholar 

  • Vaccari-Mazzetti MP, Martins DMFS, Mauro LDL et al (2003a) Síndrome de goldenhar. Arq Catarin Med 32(s1):96–100

    Google Scholar 

  • Vaccari-Mazzetti MP, Martins DMFS, Mauro LDL et al (2003b) Distração óssea mandibular e ortopedia maxilo - mandibular. Arq Catarin Med 32(s1):88–95

    Google Scholar 

  • Vaccari-Mazzetti MP, Martins DMFS, Bastos JAV et al (2006a) Síndrome de 10 e 20 arcos viscerais: microsomia hemifacial unilateral, bilateral, síndrome de goldenhar, disostose mandíbulo-facial. In: Stochero IN, Tourniex AAB (eds) Cirurgia Plástica. Robe Santa Isabel, São Paulo

    Google Scholar 

  • Vaccari-Mazzetti MP, Roxo CEMB, Bastos JAV et al (2006b) Distração óssea mandibular e maxilo – ­mandibular. In: Stochero IN, Tourniex AAB (eds) Cirurgia Plástica. Robe Santa Isabel, São Paulo

    Google Scholar 

  • Vaccari-Mazzetti MP, Kobata CT, Brock RS (2009a) Distração Óssea Maxilar na Sequela de Fissura Lábio Palatina. Relato de Caso. Arq Catarin Med 38:49–51

    Google Scholar 

  • Vaccari-Mazzetti MP, Kobata CT, Brock RS (2009b) Distração Osteogênica e Tratamento Ortopédico na Síndrome de Pierre Robin. Arq Catarin Med 38:52–54

    Google Scholar 

  • Vaccari-Mazzetti MP, Kobata CT, Brock RS (2009c) Diagnóstico Ultrassonográfico Pré-natal da Fissura Lábio-palatal. Arq Catarin Med 38:130–132

    Google Scholar 

  • Vaccari-Mazzetti MP, Martins DMF, Gomes PO et al (2009d) Distração Óssea na Disostose Mandíbulo-facial: Revisão da Literatura. Rev Bras Cir Craniomaxilofac 12:29–33

    Google Scholar 

  • Vento RA, La Brie RA, Mulliken JB (1991) The OMENS classification of hemifacial microsomia. Cleft Palate Craniofac J 28:68–73

    Article  PubMed  CAS  Google Scholar 

  • Viterbo F, Barreto LCL (2000) Malformações e assimetrias das orelhas. In: Zanini AS (ed) Cirurgia craniofacial- malformações. Revinter, Rio de Janeiro

    Google Scholar 

  • Williams JPK, Maull D, Grayson BH, Longaker MT, McCarthy JG (1999) Early decannulation with bilateral mandibular distraction for tracheostomy dependent patients. Plast Reconstr Surg 103(1):48–59

    Article  PubMed  CAS  Google Scholar 

  • Winokur ST, Shiang R (1998) The Treacher Collins syndrome (TCOF1) gene product, treacle, is targeted to the nucleolus by signals in its c-terminus. Hum Mol Genet 7(12):1947–1952

    Article  PubMed  CAS  Google Scholar 

  • Yasui N (1991) The effect of the distraction upon bone, muscle and periosteum. Orthop Clin North Am 22(4):563–567

    PubMed  CAS  Google Scholar 

  • Zanini AS (2000) Disostoses mandíbulofaciais ou síndrome de Treacher – Collins. In: Zanini AS (ed) Cirurgia craniofacial- malformações. Revinter, Rio de Janeiro

    Google Scholar 

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Vaccari-Mazzetti, M.P., Avelar, J.M., Avelar, T.M. (2013). Craniofacial Anomalies Associated with Microtia: Importance of Its Repair Before, During and After Ear Reconstruction. In: Ear Reconstruction. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35683-4_13

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  • DOI: https://doi.org/10.1007/978-3-642-35683-4_13

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