Distraction lengthening of the mandibular costochondral graft: a precautionary note

Distraction osteogenesis of bone-grafted mandibles has been shown to occur without undue difficulties in bone regeneration and healing. In the patient with hemifacial microsomia for which early costochondral graft reconstruction has been done, secondary distraction lengthening may still be needed eventually. It is important to assess preoperatively that the superior portion of the graft is properly positioned against the residual glenoid fossa to prevent excessive superior movement of the proximal mandibular segment during distraction. The case presented clearly illustrates this unique distraction phenomenon.