Management of the Ramus Condyle Unit in the Patient with Hemifacial Microsomia

Hemifacial microsomia (HFM) is a specific condition that describes the unilateral incomplete or hypoplastic development of the facial soft tissues, ear and skeleton. HFM is the second most common facial birth defect after cleft lip and palate with incidences ranging from 1 in 3,500 live births. Traditional methods for reconstructing the absent joint and ramus in HFM include autogenous bone grafts, distraction osteogenesis and alloplastic reconstruction. The focus of this lecture is to discuss the condition and its treatment options.

Learning Objectives

At the conclusion of this program, participants should be able to:

  1. Explain when and how to manage the TMJ and resultant skeletal deformity in patients with hemifacial microsomia. 
  2. Describe when and how to reconstruct the TMJ in patients with hemifacial microsomia using costochondral grafting or a total joint prosthesis. 
  3. Identify the long- and short-term results as well as pitfalls of costochondral grafting vs alloplastic reconstruction in the HFM patient. 

George Zakhary, DDS, MD, FACS
UCSF Fresno
Fresno, CA
Relevant Conflict of Interest Disclosure: No Relevant Conflict of Interest Disclosures were reported.

Daniel Perez, DDS, MS
UT Health San Antonio
San Antonio, TX
Relevant Conflict of Interest Disclosure: No Relevant Conflict of Interest Disclosures were reported.

An Internet-based CME Activity
Original Release Date: September 19, 2019
Review Date: May 14, 2022
Expiration Date: May 14, 2025
Estimated time to complete this educational activity: 0.75 hours
Method of participation: Self-Study

George M. Zakhary, DDS, MD, FACS

Assistant Professor, UCSF Fresno Dept of OMS, Pediatric Cleft Craniofacial

George M. Zakhary DDS, MD, FACS
Assistant Professor
UCSF Fresno Deptartment of Oral & Maxillofacial Surgery
Medical Director UCSF Fresno CRMC Cleft & Craniofacial Team

Daniel E. Perez, DDS, MS

Associate Professor & Program Director, UT Health San Antonio

Dr. Daniel Perez is currently the program director and an Associate Professor in the Department of Oral & Maxillofacial Surgery at the University of Texas Health Science Center at San Antonio. Dr. Perez was born in San Jose, Costa Rica where he obtained his dental degree from the University of Costa Rica. He completed his residency at the Pontificia Universidad Javeriana. After that he returned to Costa Rica and that same year was accepted in a fellowship program in Orthognathic and TMJ Surgery under the supervision of Dr. Larry M. Wolford at Baylor University Medical Center in Dallas. He then completed and moved to San Antonio to join the program. Dr. Perez's field of interests includes: trauma, facial reconstructive surgery, temporomandibular joint disorders, sleep apnea, and orthognathic surgery among others. 

Key:

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Faculty and Planner Disclosure
Pre-Quiz
3 Questions  |  1 attempt  |  0/3 points to pass
3 Questions  |  1 attempt  |  0/3 points to pass
Management of the Ramus Condyle Unit in the Patient with Hemifacial Microsomia (Dr. Zakhary)
Open to view video.
Open to view video.
Management of the Ramus Condyle Unit in the Patient with Hemifacial Microsomia (Dr. Perez)
Open to view video.
Open to view video.
Post-Quiz
3 Questions  |  Unlimited attempts  |  2/3 points to pass
3 Questions  |  Unlimited attempts  |  2/3 points to pass
Evaluation
11 Questions
Certificate
0.75 CDE/CME credits  |  Certificate available
0.75 CDE/CME credits  |  Certificate available