The second parotid arch developmental abnormality, the correct name should be hemifacial microsomia, many domestic units still use the old name. General small ear deformity of many actually is hemifacial microsomia, the ear is one of the manifestations, there is also the hypoplasia of the mandible, which may cause the corresponding poor development of the maxilla, resulting in facial asymmetry. Treatment 1, If there is a lesion of the angle of the mouth, 3 months surgery. 2, poor mandibular development, 3-12 months for bone lengthening; Chai Gang, Department of Plastic Surgery, Ninth People’s Hospital affiliated to Shanghai Jiaotong University School of Medicine 3, if not found early, wait until 2-6 years old after the bone grows, because of the onset of the side of the mandible does not develop, restricting the development of the maxillary bone, and the mouth will be crooked in the future; 4, 6 years old to do ear surgery 5, after the age of 16 years old, you should do the surgery Half-face shortness Skeletal lengthening Why should we extend the mandible as early as possible: Hemifacial microsomia, the main manifestation is the underdevelopment of the mandible, a large part of it actually only affects the mandible, but a lot of adult patients have obvious crookedness of the corners of the mouth, and at the same time, the teeth are obviously high and low, which is obvious when you smile. The main reason for this is that the underdeveloped mandible restricts the normal development of the maxilla, resulting in a series of facial deformities. Therefore, it is important to lengthen the mandible as soon as possible to allow the other bones to develop. Time of surgery: Best within 1 year of age. Anyone without medical knowledge can see that 0-1 years of age is the peak of skeletal development in the head, which can change on a daily basis. Semi-facial shortness is a relatively common congenital disease, if active treatment can be cured, the original domestic treatment started relatively late, many organizations and doctors still stay in the concept of growing up surgery, a small number of units began to extend the child’s age 3-6 years old, but based on the concept of the literature more than ten years ago, the main reason is that the domestic doctors have fewer opportunities for international exchanges, and the literature published by foreign countries are generally the results of many years ago. The main reason is that domestic doctors have fewer opportunities for international exchanges, and the literature published abroad is generally the result of many years ago. Last year, when I was in the best craniofacial center in the world for exchange, I saw many adult patients who had been operated in childhood, almost exactly as normal, and realized that they had started to operate in infancy and early childhood a long time ago to extend the length of the surgery, and because of the rapid developmental period, the surgical results were very good, and I only saw the publication of their articles after I went back to China, which is actually more than 10 years behind the domestic situation. This is the main reason why the results of surgery in China are not very good in many children aged 4-6 years. However, this situation will improve significantly in the future, and the number of patients in China and the accumulation of experience of doctors will soon be able to make up for the current gap. Preparation before the surgery of half face short bone lengthening: to carry out fine CT examination, do not recommend X-ray, no sense to eat more light, the results of the examination must be engraved into a CD-ROM, to do the three-dimensional design before the operation, local hospitals, if the examination, the requirements of the CT layer thickness of 1mm, DICOM data to be engraved on a disk, must choose 16 rows of CT, the dose of radiation to the baby is also small. In addition, you can’t catch a cold before the surgery, and your nutrition should be up to date, and you can’t have anemia. Half face short bone lengthening process Surgery should be used in the international common combined method of inside and outside the mouth, the incision in the back of the ear, there should be a very small hole under the chin for lengthening, in this regard plastic surgery has a great advantage, in fact, the incision behind the ear is generally the standard location of cosmetic surgery facelift, very hidden, many domestic doctors of other disciplines from the lower part of the mandible surgery, this is mainly because of the relevant other specialties of the doctor are only trained in oncologic surgery and do not have a foundation in plastic surgery, and surgery from below the jaw can result in significant scarring. Simple intraoral incision Suitable for older children and adults, generally in infants and young children are not have sufficient space in the mouth to know the direction of lengthening must be very precise to have good results. Surgical precision safety assurance, the only full digital surgery in China, including pre-surgical 3D surgical design, pre-surgical 3D printing model verification, surgical augmented reality surgical navigation, these latest technologies to ensure the accuracy of children’s surgery. Bone surgery for infants and young children requires a lot of equipment to ensure absolute precision and very accurate surgical design and navigation. Generally speaking, there are only a few craniofacial centers in the world that can carry out bone lengthening surgeries for infants and young children, and there are only three centers in the United States that can carry out similar surgeries. At present, our team treatment used are the best equipment, CT to the Shanghai specialized children’s hospital, CT high precision, fast scanning speed; surgery before the need for three-dimensional surgical design, prior to the full three-dimensional surgical rehearsal, the United States imported three-dimensional printer for the design of the model, the operation of the special navigation equipment, the entire mathematical equipment worth nearly ten million, is through the five-year-long investment in the country long-term! The entire mathematical equipment worth nearly ten million dollars, is through a long-term investment of five years of national support, if there is no similar hardware equipment is not recommended to carry out similar surgery, infants and young children very small error grows up to be a thousand miles. Surgery hospitalization is generally 3-7 days, 3 days after the operation began to extend the general see once parents can operate on their own, the actual patient is not any sensation, the bones do not have a lot of nerves. The patient is not conscious and there are not many nerves in the bones. Generally, the procedure can be performed twice a day, and it takes about 1 minute a time. It can be done at home. Generally according to the design plan before surgery and the actual situation, 20-30 days can be, in fact, in a month, so that the rapid development of the jawbone, and soon the face began to be symmetrical, the parents will be very accomplished at this time, but must remember to properly extend a portion of the more, in order to be used to compensate for the future development of the lack of. Then begins the 3-6 month wait where the extender is left in place to allow the formed bone to fully mature. The extender is then removed and you are done. Common problems: 1, mandibular lengthening is the most fundamental measure for the treatment of hemifacial shortness, the main purpose of the surgery is to return the length of the mandible, while making room for the development of the maxilla, the earlier the surgery, the better, 3 months can meet the requirements of anesthesia can be operated on. 2. The earlier the surgery for facial asymmetry, the better, and it helps a lot for ear surgery after the age of 6. Otherwise, it is difficult to position the new ear to the same level as the normal ear 3. Of course, in childhood, as long as the maxillary bone is still able to develop, it can be operated. After the age of 16, unless the patient is very serious, the orthognathic surgery is usually used. Mild and moderate ones should not be prolonged, otherwise the safety of orthognathic surgery will be affected. 4, crying and laughing when the mouth is crooked, sleep right eye closure is not good because of the development of the facial nerve problems, most of the patients with a short half face have a certain degree of facial nerve problems exist, with the growth and development of gradually have some improvement, daily massage face acupuncture points at present there is no scientific evidence of any help, will be unfavorable to the development of the muscles. The cost of surgery, depending on the extender, the domestic extender is generally 8,000, imported 18,000, how to choose the doctor is also more entangled, generally according to the actual design of the choice of a specific model, domestic cheap but not very stable, there will be a certain quality of the accident, happened more cases of falling off and fracture, but of course the vast majority of the good, while the operation is also relatively simple; imported high price is mainly the problem of tax links, of course, Germany and the United States, and the United States, and the United States. Is the problem of the tax link, of course, Germany and the United States production process is still a big gap between the domestic leading, very accurate and stable quality, almost no accidental problems occur, the only thing is not particularly small models. Suggested according to their own economic conditions to consider.