| Abstract: |
Craniofacial microsomia is the second most common congenital craniofacial difference. It is characterized by abnormalities of structures derived from the first and second branchial arches. The degree of involvement is very variable. The SAT and OMENS classification systems incorporate soft tissue in their schemes. The extent of soft tissue deficiency is related to the severity of the mandible deformity. Soft tissue structures that can be affected include the skin, subcutaneous tissue, parotid gland, muscles of mastication, ear (microtia), eyes (dystopia, microphthalmia), and oral commissure (macrostomia). Soft tissue volume correction can be achieved with soft tissue flaps, fat grafting, and alloplastic implants. Structural fat grafting has become popular as it is the least invasive of all techniques, has minimal donor site morbidity, and can be performed in conjunction with other reconstructive procedures. Facial nerve palsy is found in 22-45% of children with craniofacial microsomia. The palsy can be partial or complete and can involve specific nerve branches or the entire nerve. The most urgent priority is corneal protection and prevention of vision deterioration. Various static and dynamic procedures have been described for restoration of facial function and aesthetics. The ultimate goal is rehabilitation of spontaneous movement of facial musculature. © Springer Nature Switzerland AG 2022. |
