Hemifacial microsomia: extraoral appliance for the early treatment of an infant. Literature review and case report.

In this report a description of the different features of hemifacial microsomia is given and a new way of early treatment of concomitant respiratory problems is presented. An extraoral appliance was developed for the treatment of an infant affected with this syndrome. The purpose was to temporarily minimize the child's repeated respiratory disturbances, which were probably caused by glossoptosis, until an autologous costochondral graft in the mandibular ramus could be performed. An improvement of respiration, of facial asymmetry and even a stimulation of mandibular growth was observed. It is claimed that the use of this appliance can help to avoid tracheotomy in many severe cases of uni- or bilateral facial microsomia with glossoptosis and apnea. This treatment should be considered as temporary until the general condition of the patient has improved and grafting is possible.