Surgical Assisted Rapid Maxillary Expansion in Hemifacial Syndrome Patient Post Primary Cleft Treatment: A Case Report

Abstract

Introduction: Cleft lip and palate is a congenital malformation resulting from an incomplete or incorrect fusion during embryonic development. Hemifacial syndrome is one of rare orofacial anomalies with midface hypoplasia. Maxillomandibular deformity repair for maxillary hypoplasia can be achieved by repositioning the maxilla and mandible to correct occlusion, mastication, functional issues, cosmetic concerns, and facial symmetry. The main concerns in the case of maxillary hypoplasia are the repair of transverse (narrowing of the maxilla), sagittal (anterior posterior), and vertical (facial proportion) aspects. This study aimed to elucidate the treatment for patients with maxillary hypoplasia by utilizing the surgical assessment of rapid maxillary expansion (SARME) following cleft lip and palate surgery.

Case Report: A 21-year-old female patient had symptoms of a truncated maxilla, compromised speech, and challenges with mastication and ingestion. The patient’s surgical history includes having undergone labioplasty, palatoplasty in 2002, and gnatoplasty in 2023. The recommended treatment for this situation involves SARME. The patient’s speaking and feeding difficulties were caused by both transversal and vertical problems in the patient with maxillary hypoplasia. This is why the therapy was necessary.

Case Management: Implementation of surgical assessment rapid maxillary expansion (SARME).

Conclusions: This case report concludes a notable improvement in the upper and lower jaw’s functional, masticatory, and aesthetic aspects in a patient with maxillary hypoplasia. This improvement was achieved with surgical assisted of rapid maxillary expansion (SARME) following primary cleft lip and palate surgery.

Keywords: Cleft lip and palate, Hemifacial syndrome, SARME