Hemifacial microsomia is a condition that is present at birth that causes the face to develop so that the features are not symmetric. It most commonly affects the eyes, ears, jaw, and the ability to smile evenly.
You may also hear hemifacial microsomia called Goldenhar syndrome and oculo-auriculo vertebral syndrome.
The most obvious symptom of hemifacial microsomia is asymmetry between the two sides of the face. Some of the more common deformities include:
Other symptoms can include asymmetries between the amount of fat in the cheeks and the muscles and nerves on each side of the face. Because muscles and nerves in the face are necessary for functioning, these issues are typically corrected.
Rare but severe cases of hemifacial microsomia may see asymmetries in other parts of the body like the kidneys, spine, and heart.
It’s not known yet what causes hemifacial microsomia. Scientists that research the condition currently believe that the condition develops when an artery that supplies blood to the head is injured or develops abnormally while the baby is in the womb. More research is needed to support this theory. Very few cases of hemifacial microsomia have been shown to be inherited or caused by a genetic mutation.
Diagnosis can be made before or after birth based on abnormal facial features. Hemifacial microsomia is visible in an ultrasound before birth. Many babies are not diagnosed until after birth. A team of physicians typically evaluates the severity of hemifacial microsomia, including a paediatrician, an ear, nose, and throat doctor (ENT), and a plastic surgeon, to start. As your child grows, a member of their care team may order X-rays or a computerised tomography scan to get a better idea of how involved your child’s hemifacial microsomia is. However, your OB/GYN or child’s primary care physician should be able to make a diagnosis before or after birth and refer you to specialists.
There are no known complications of hemifacial microsomia.
Treatment for children with hemifacial microsomia can include ear reconstruction, hearing aids, the creation of a new ear canal, a muscle graft that allows children to learn to smile symmetrically, and fat grafting to make the face more symmetrical. Supportive care may also be necessary at birth depending on the severity of the condition.
Discuss potential procedures to treat symptoms of hemifacial microsomia with your child’s plastic surgeon. Many parents ask if there’s anything they could have done to prevent hemifacial microsomia, and the answer is no. There’s no way to prevent it that anyone is aware of at this time.
Follow-up care will be necessary to monitor the health of your child, but lifetime outlook is good for children with hemifacial microsomia.