Hemifacial Microsomia Associated With Vascular Malformation Of Vertebral: A Case Report

Arif Tri Prasetyo¹, Indri Lakhsmi Putri^1,3,4, Anggun Esti Wardani²

¹ Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia

² Department of Radiology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia 

³ Universitas Airlangga Hospital, Surabaya, Indonesia

⁴ Airlangga Health Science Institute

Abstract

Background : Hemifacial microsomia (HFM) consist of complex facial malformation with a wide spectrum of clinical features involving the facial skeleton and other organ systems. There is no evidence about Hemifacial Microsomia associated with vascular malformation of vertebral or otherwise.

Methods : Reporting a 12 year old male with HFM and left Microtia. Prior to this admission, reconstruction of left auricle was done. However, the flap was necrosis. We plan to conduct further reconstruction, preceded with CT angiography to find available flap modalities to close the defect of the auricle. From CT angiography accidentally we found a vascular malformation of vertebral. There was a tortuosity of left vertebral vein with the diameter of the left is bigger than the right. The diameter of left internal jugular artery is smaller than the right. The maxillary artery remain the same. There is no submental artery on the left side and there is a hypoplasia of left angularis artery.

Conclusion : Hemifacial microsomia could be associated with other malformations. Despite the fact that vertebral artery anomaly is not considered common anomaly in HFM, it is mandatory to perform CT angiography before reconstructive surgery, considering the possibility of massive bleeding during the operation.

Keywords: Hemifacial microsomia, Vertebral vein malformation, Microtia, CT angiography, Vascular anomaly