Restoration of facial contour in Romberg's disease and hemifacial microsomia: Experience with 118 cases

The experience with free flaps and conventional reconstructive procedures f or 118 patients with Romberg's disease and hemifacial microsomia over a 10- year period is presented. The groin free flap was used most frequently for patients with Romberg's disease, whereas the scapular free flap was used fo r patients with hemifacial microsomia. The rectus abdominis or the latissim us dorsi free flap was chosen only when additional volume was required. To achieve better contour, secondary procedures, such as defatting the flap, p edicled temporal fascial flaps, cartilage and bone grafts, orthognathic sur gery, and bone distraction were performed in severe cases. For patients wit h Romberg's disease, excellent results were achieved in 35% (n = 28) of mil d cases, in 72% (n = 27) out of 38 moderately and in 41% (n = 5) out of 12 severely affected patients. In hemifacial microsomia group (n = 40) excelle nt results were obtained in 66% of cases. (C) 2000 Wiley-Liss, Inc.