Progressive Overgrowth of Costochondral Graft in a Case of Hemifacial Microsomia: A Rare and Severe Case.
Lobredia Zarasade, Carolus Aldo Windura, Magda R Hutagalung et al.
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Case in brief
A 17-year-old male with hemifacial microsomia developed progressive overgrowth of a costochondral graft used to reconstruct the mandibular condyle. Despite previous corrective surgeries, he had severe facial asymmetry, a 2.5 cm ramus discrepancy, and marked mandibular deviation. Management involved staged correction with graft excision, osteotomies, and genioplasty.
What made this case unusual
The graft continued to overgrow beyond skeletal maturity, producing severe asymmetry despite prior corrective surgery.
Diagnostic / clinical pearl
Costochondral graft growth can be unpredictable; progressive facial asymmetry after reconstruction warrants assessment for graft overgrowth.
Why it matters
The case highlights the need for long-term surveillance and individualized planning after costochondral graft reconstruction.