Hemifacial microsomia is a condition where one side of the face is underdeveloped. It is the second most common craniofacial difference, after clefts. Currently, we believe hemifacial microsomia is caused by some factors which affect the development of the face during the first trimester of pregnancy. It is not caused by anything a parent did or did not do. Genes are not believed to be involved. This means it is not inherited and will not be passed on from parent to child. If a couple has a child with hemifacial microsomia, there is about a 3% chance they will have another child with the condition.
Although children with hemifacial microsomia may look different, most children have normal intelligence. As children grow and develop, concerns about self esteem and self confidence become a critical part of the treatment plan.
Hemifacial microsomia may vary in severity. The lower face is usually vertically shortened because the mandible (lower jaw) is underdeveloped. Hemifacial microsomia can involve the entire face including the eye and eye socket, cheek, and ear. If the ear is involved it may be underdeveloped, differently shaped, or even absent. Sometimes there are skin tags in front of the ear. Hearing and speech may be affected. If the forehead or skull is also involved, we use the term “craniofacial microsomia”
Goldenhar syndrome (also know as oculoauricular dysplasia) is a very similar condition; however, children with Goldenhar have a few additional findings. These include neck problems and benign growths on the eye called epibulbar dermoids.
TREATMENT OF HEMIFACIAL MICROSOMIA
Treatment is complex and usually requires multiple stages. The skull, eye socket and cheek bones are generally reconstructed when children are young. Timing for jaw reconstruction will vary depending on whether there are breathing or feeding problems. Ear reconstruction usually occurs in the school age years.
Children with hemifacial microsomia require long-term follow up by a multidisciplinary team. This is a complex condition and experts from different medical, surgical, and dental specialties need to work together to provide the best care for your child. Several operations may be needed as children grow.
It is very important for children with hemifacial microsomia to receive dental care from providers experienced in caring for children with craniofacial conditions. Our dental medicine team is the most experienced in treating children with complex craniofacial needs. Read more about our dental medicine experts.