Background: Goldenhar syndrome, also known as oculo-auriculo-vertebral spectrum or hemifacial microsomia, is a rare congenital condition characterized by craniofacial, ocular, auricular, and vertebral anomalies. Its incidence ranges from 1 in 3,500 to 1 in 5,600 live births, with underdiagnosis contributing to its low reported prevalence in India.

Objective: To evaluate the clinical outcomes of distraction osteogenesis in patients with Goldenhar syndrome and highlight the importance of a multidisciplinary approach in achieving functional and aesthetic rehabilitation.

Methods: A retrospective analysis was conducted on patients diagnosed with Goldenhar syndrome who underwent distraction osteogenesis for mandibular deformities. Treatment planning was individualized based on skeletal maturity and severity of asymmetry. Orthodontic therapy was integrated to correct occlusal discrepancies and enhance postoperative stability. Clinical and radiographic assessments were used to evaluate outcomes.

Results: All patients demonstrated significant improvement in facial symmetry and underlying bone growth. Distraction osteogenesis facilitated early intervention, avoided donor site morbidity, and minimized the need for bone grafting. No major complications such as distractor malfunction or vector loss were observed. Orthodontic support contributed to long-term occlusal stability. Kaban’s treatment objectives were successfully achieved in all cases.

Conclusion: Distraction osteogenesis is a reliable and minimally invasive technique for correcting mandibular asymmetry in Goldenhar syndrome. When combined with orthodontic and multidisciplinary care—including ophthalmology, ENT, neurosurgery, and orthopedics—it offers optimal functional and psychosocial outcomes. Early diagnosis and individualized treatment planning are key to successful rehabilitation.