| The first and second branchial arch syndrome is a common congenital craniofacial malformation, whose incidence is second only to that of cleft lip & palate. This syndrome involves multiple adjacent anatomic structures, and its clinical manifestations are complex and variant. About the treatment of this syndrome, consistent views have not been agreed on. In this paper, we reviewed the relating literatures of past 30 years, and put forward a 'simultaneous project' to treat the auricular and jaw deformities simultaneously. In this project, 'skin expansion two-stage ear reconstruction', mandibular lengthening by gradual distraction or/and local augmentation with autogenous costicartilage grafts were conducted at the same time. We also measured the lower face of patients with congenital microtia to analyze the jaw deformities' characters of such patients, carried out animal experiments to establish the consolidation period of mandibular distraction osteogenesis.Having reviewed the past 30 years' literatures, we thought the key points of this syndrome were two aspects, microtia and mandible hypoplasia on the affected side which leading to facial asymmetry. By several generations' efforts in nearly hundred years, ear reconstruction operation was considerably mature, especially skin expansion two-stage method had been used in thousands patients in recent 10 years by Professor Zhuang HX. On the other hand, about the treatment of facial asymmetry, there had been three representative therapeutic methods after 1980's, San Francisco Program, Toronto Program and New York University Program. In all the three programs, experts put the emphasis on combining early and extensive surgery with other assistant therapy to correct the craniofacial malformation, but they didn't take microtia into account, or didn't pay enough attention to this question. In fact, either ear reconstruction or facial asymmetry's correction is very important. Only the two... |
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