Children born with hemifacial microsomia will have underdevelopment of one side of their face, usually involving the ear, mouth and jaw. One side of the face will usually appear smaller than the other. The outer ear may be malformed or absent. Children may have hearing and speech difficulties. The severity can vary greatly between children. In more severe cases, a child’s skull, teeth, jaw muscles, middle ear and upper jaw may also be affected.
Other common names:
Brachial arch syndrome, facio-auriculo-vertebral syndrome, oculo-auriculo-vertebral spectrum, lateral facial dysplasia
The exact cause of hemifacial microsomia is unknown. It could be caused by a burst blood vessel in the face during development in-utero, which could cause slowed growth in that side of the face. It usually occurs sporadically, however research has indicated occurrences of more than one case in a family.
Hemifacial microsomia can also be an indication of Goldenhar syndrome, where a child will have abnormal growths on the eye and spinal deformities as well. With proper treatment, this syndrome generally has a very positive prognosis.
Because hemifacial microsomia affects each child different, they should be evaluated by a comprehensive craniofacial team. Treatment may involve surgery on the jaw including bone grafts and surgery to correct the outer ear. Speech therapy may also be necessary. Because growth is permanently inhibited on the affected side of the face, children will need to continue to be seen throughout adolescence.
Most children born with hemifacial microsomia are able to lead healthy lives.