FREE DIFFERENTIAL THICKNESS DE-EPITHELIALISED ANTEROLATERAL THIGH FLAP FOR SEVERE HEMIFACIAL ATROPHY IN A CHILD – A CASE REPORT

Abstract

Parry Romberg syndrome (PRS), also known as progressive hemifacial atrophy is a rare self-limiting degenerative neurocutaneous and craniofacial disorder, typically affecting one half of the face occurring in children and young adults which causes functional, aesthetic and psychological disabilities with social implications in the affected individual. It is characterized by atrophy of the skin, fat, muscles and underlying bone and cartilage affecting the face and neck unilaterally. It is associated with neurological symptoms like epilepsy and involvement of other organs like the eye. It has a slow and progressive course and its cause remains largely unknown. It was been noted that this condition is more common in females. Neuroimaging with computed tomography (CT) scan aids in demonstrating radiological features, assessing disease severity, and detecting neurological and ocular complications. The diagnosis was based on clinical features. A multidisciplinary team approach involving rheumatologists, dermatologists, plastic & maxillofacial surgeons, ophthalmologist, paediatrician, neurologist and psychologists are required for the management of this problem. We present a case of PRS in a 9-year-old female child with gross facial asymmetry, with marked wasting and atrophy involving the entire right side of the face for which a differential thickness de-epithelialised free anterolateral thigh flap was done to correct the deformity.