A decade of clinical research on clinical characteristics, medical treatments, and surgical treatments for individuals with craniofacial microsomia: What have we learned?

Ruben W Renkema,Cornelia J.J.M Caron,Carrie L Heike,Maarten J Koudstaal

doi:10.1016/j.bjps.2022.02.058

Ruben W Renkema, Cornelia J.J.M Caron + Show 2 more

Open Access

https://doi.org/10.1016/j.bjps.2022.02.058

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Abstract

AimThis article provides a review of a decade of clinical research studies on clinical features, medical interventions, and surgical interventions for individuals with craniofacial microsomia (CFM). We also provide recommendations for future clinical research. MethodA systematic search of literature was conducted in Embase and PubMed/MEDLINE Ovid. All publications from 2010 to 2020 that included at least 10 individuals with CFM were considered relevant for this study. ResultsA total of 91 articles were included. In the past decade, many new studies on CFM have been published providing more insight on the diagnosis and management of patients with CFM. This review encompasses findings on the clinical difficulties patients with CFM encounter, including the craniofacial and extracraniofacial characteristics of patients with CFM and its related clinical consequences on breathing, feeding, speech, and hearing. ConclusionsA considerable number of large multicenter studies have been published in recent years, providing new insights in the clinical consequences of CFM. The phenotypic variety between patients with CFM makes patient-specific treatment tailored to individual needs essential. The research and development of clinical care standards might be challenging because of the heterogeneity of CFM. Future research on clinical and patient-reported outcomes can help identify optimal treatment strategies. Cooperation between craniofacial centers, using uniform registration and outcome measurement tools, could enhance research and future care for these patients. Level of evidenceLevel IV.

Highlights

This article aimed to give an overview of new insights on craniofacial microsomia (CFM) that were published in the last decade
Large retrospective studies showed that no distinct phenotypic subgroups within cohorts of patients diagnosed with CFM have been identified, suggesting CFM is a continuous spectrum varying in type and severity of affected structures
Mandibular hypoplasia can be associated with obstructive sleep apnea

Summary

Introduction

No significant difference in the need for orthognathic surgery at skeletal maturity between both groups was observed.[67] Weichmann et al studied the long-term results of early MDO performed at a mean age of 3 years in 19 patients with mild CFM (Pruzansky-Kaban type I and IIa).

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