Facial Asymmetry: Management of the Oculoauriculovertebral Spectrum (OAVS)

Oculoauriculovertebral spectrum (OAVS) is a condition characterized by hypoplasia as a result of disrupted development in the first and second branchial arches. Its craniofacial manifestations are often unilateral and the term hemifacial microsomia has been frequently used. Because the phenotypes of OAVS patients are extremely diverse, treatments are individualized and based on the needs of patients on a case-by-case basis. In the absence of significant functional deficits or severe psychosocial esthetic concerns, surgical intervention is the most stable and predictable when performed at or near the completion of growth of the functional unit to be treated. For patients with a severe phenotype, staged reconstruction involving multiple surgeries at various stages of development may be indicated. Others may never require surgical intervention. The skeletal facial asymmetries commonly seen in patients with OAVS are often most successfully managed with traditional orthognathic jaw surgery near the completion of growth of the facial skeleton.