Hemifacial microsomia

Case contributed by Dr Ian Bickle


Facial asymmetry from childhood. Sensioneural hearing impairment. Prior reconstruction of left sided microtia.

Patient Data

Age: 13 years
Gender: Male



Status post left pinna reconstruction.

Dysplastic unpneumatised left mastoid air cells.

No left external auditory canal.

The ossicles of the left middle ear are gracile.


The left ramus of the mandible is small and deformed with a dysplastic mandibular condyle and coronoid process.

No glenoid fossa and hence no articulation with the mandibular condyle.

Small bony protruberance on the medial aspect of the mandibular body.

The mandible is shortened by approximately 2cm.


1. Left hemifacial microsomia: Pruzansky IIb

2. Left external auditory canal atresia and corrected microtia



The 3D computer printed stereolithographic model produced from the CT data set for surgical planning.

Case Discussion

Various classifications have been developed to grade the degrees of hemifacial microsomia.

Pruzansky described ear and mandible deformities into grades I to III.

This case is an example of a Pruzansky IIb.

3D printing used in other walks of life is now used for modelling purposes prior to surgery.  These are produced from the raw CT dataset.

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