Three-Dimensional Approach to Analysis and Treatment of Hemifacial Microsomia [1]

In Dr. Leonard Kaban’s 1981 paper entitled, “Three-Dimensional Approach to Analysis and Treatment of Hemifacial Microsomia” (Kaban et al., Cleft Palate J. 18:90–99, 1981), the authors challenged the single radiograph assessment paradigm. The study published in the Cleft Palate Journal proposed a three-dimensional analysis utilizing sagittal, anteroposterior, and submental X-ray views to fully classify the defect utilizing the authors’ experiences with a cohort of 40 patients with hemifacial microsomia (Fig. 16.1). The Kaban study was the first to describe hemifacial microsomia in more than one dimension in the era before readily available computed tomography (CT). Prior to this, the lateral cephalogram was used commonly to describe the deformity in one plane. The report changed the assessment of hemifacial microsomia and improved the understanding of the primary and secondary deformity. The assessment remains important when planning treatment of hemifacial microsomia despite CT long becoming the standard of care in craniomaxillofacial surgery.