HemifacialMicrosomiaClassification

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Classificationsystems
OMENS+
Pruzansky
Classificationsystems
SeveralclassificationsystemshavebeenproposedespeciallybyPruzansky
(1982),Lauritzenetal(1985),David(1987),Ventoetal(1991),andHorganetal
(1995).ThemostcomprehensiveclassificationsystemisOMENS+asdescribedby
Horganetal.However,surgeonsfindtheclassificationoftheskeletaldeformityby
Pruzansky,asmodifiedbyKaban(whichisincorporatedinOMENS+)tobemost
usefulinpractice.
OMENS+
OMENS+subdividesandgradeseachoftheprincipaldeformities.Theseare:
O=Orbit
M=Mandible
E=Ear
N=Nerves
S=SoftTissues
+=Extracraniofacialfeatures
Pruzansky
Pruzanskysubdividestheearandthemandibledeformities.
Mandible
Iasmallramuswithidentifiableanatomy
IIafunctioningTMJbutwithanabnormalshapeandglenoidfossa(IIaandIIbas
modifiedbyKaban)
IIatheglenoidfossaisinanacceptablefunctionalposition
IIbtheTMJisabnormallyplacedandcannotbeincorporatedinthesurgical
construction
IIIanabsentramusandnonexistentglenoidfossa
Thissystemhastwoweaknesses.
ItispossibletohaveaPruzanskyIIwithafunctioningTMJbutwithorwithouta
zygomaticarchandglenoidfossa.
ItispossibletohaveaPruzanskyIIIwithnocondyleandnofunctioningTMJ
withorwithoutazygomaticarchandaglenoidfossa.
3DCTenablesclassificationofthiscondition.

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PruzanskyI

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PruzanskyI

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PruzanskyIIa

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PruzanskyIIa

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PruzanskyIIb

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PruzanskyIIb

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PruzanskyIII

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PruzanskyIII