Mandibular hypoplasia is an underdevelopment of the lower jaw that can be congenital or caused by trauma. It can lead to complications such as difficulty breathing and swallowing. Treatment involves reconstructive surgery.
Broken down in its literal definition, mandibular hypoplasia means an incomplete jaw. “Mandibular” is the anatomical term that refers to the lower jaw or mandible and “hypoplasia” is a medical term that refers to an underdevelopment or growth of a body part. Mandibular hypoplasia is therefore the incomplete or underdevelopment of the jaw. Micrognathism, a condition in which the lower jaw is undersized, is another term that essentially means the same thing.
Mandibular hypoplasia is often a congenital condition, but it can also occur as a result of trauma or injury. The cause of congenital forms of this condition can vary, and a cause is not always identified in pediatric patients born with this facial malformation. Likewise, it can be just one of many specific underdevelopments that are the result of a birth defect. Other areas that can be affected include the ears, upper jaw and nose.
Clinically, this condition may present as a deviated chin with asymmetrical facial features surrounding the mouth. Complications can occur and will largely depend on the severity of the condition, but can include difficulty breathing, chewing and swallowing, which can lead to sleep apnea and weight loss or failure to thrive in newborns. In some cases, a tracheostomy or feeding tube may be required until surgical correction can be achieved.
Mandibular hypoplasia is often classified according to the Pruzansky classification system, which was developed in 1969. Other classification systems have been developed since creating subclasses of the original classification system. Pruzansky classified mandibular hypoplasia as grade 1, 2, or 3. Grade 1 refers to small mandibles regardless of normal configuration. Grade 2 refers to mandibles that are hypoplastic or underdeveloped and may fall into subclasses a or a or b depending on the malformation. Grade 3 refers to a severely underdeveloped or malformed jaw.
Treatment for mandibular hypoplasia requires reconstructive surgery. The extent of the surgery depends on the degree of underdevelopment and the configuration of the surrounding facial bones and muscles. Essentially, the jaw is reconstructed with a series of bone grafts. Reconstructive surgery is typically performed by an oral or maxillofacial surgeon, who will evaluate the condition and make recommendations based on the history, development, severity of the condition, and age. This type of reconstructive surgery is quite complex, as the lower jaw has many purposes and functions beyond being a primary facial feature of an aesthetic nature. However, many surgeries succeed in both improving facial features and correcting or alleviating complications that can occur due to hypoplasia.
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