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Hemifacial Microsomia Hemifacial Microsomia

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Hemifacial Microsomia

Hemifacial microsomia occurs when the lower half of one side of the face is underdeveloped and does not grow normally. It is also referred to as first and second brachial arch syndrome, oral-mandibular-auricular syndrome, lateral facial dysplasia or otomandibular dysostosis. The syndrome varies in severity, but always includes the under-development of the ear and the lower jaw. Hemifacial microsomia is the second most common facial birth defect after cleft lip and palette.

Children with hemifacial microsomia may have the following problems:

  • Skin tags in front of the ear or on different parts of the face
  • Hearing problems
  • Weakness in movement on the affected side of the face

Causes

Researchers are still not sure what causes hemifacial microsomia. However, most agree that something occurs in the early stages of pregnancy, such as a diminished blood supply to the first and second branchial arches. Studies do not link this condition with the mother's activities or actions during her pregnancy.

Treatment

Most children with hemifacial microsomia will need several surgeries to improve facial symmetry. Surgery can reconstruct the bony and soft tissue, and establish normal occlusion and joint junction. The timing of each surgery varies depending on the severity of the problems. Common surgeries include:

  • Lowering of the upper jaw to match the opposite side
  • Lengthening of the lower jaw
  • Ear reconstruction at about 5-6 years of age
  • Addition of bone to build up the cheekbone
  • Addition of soft tissues to further balance the face

Genetic Considerations

For parents with one child with hemifacial microsomia, there is less than a one percent chance that other children will have hemifacial microsomia. Adults with this condition have a three percent chance of passing it to their children.

Information and Resources

For more information about hemifacial microsomia, call Gillette’s Center for Craniofacial Services at 651-602-3277 or 800-719-4040 (toll-free).

To refer a patient, call 651-229-3944 or 800-719-4040 (toll-free).