What is Hemifacial Microsomia?

D. Jeffress

Hemifacial microsomia is a birth defect that disrupts the development of up to half of the face. Babies who are born with hemifacial microsomia usually suffer from mild to severe disfigurement of their ears, jaws, and mouths, which can result in significant hearing, breathing, and speaking problems. The condition has no known explicit biological or environmental cause, though medical studies suggest that insufficient blood supplies in the early stages of pregnancy may play a role. Surgeons can perform reconstructive procedures to improve the aesthetics and functionality of facial features in children with more severe hemifacial microsomia.

Babies who are born with hemifacial microsomia usually suffer disfigurement of the ears, jaws and mouth.
Babies who are born with hemifacial microsomia usually suffer disfigurement of the ears, jaws and mouth.

The first two months of a pregnancy are especially important to the healthy, normal development of an infant. Researchers believe that something occurs near the two-month mark that halts the development of the face in babies with hemifacial microsomia. The exact causes are unknown, but studies suggest that hereditary factors or physical trauma may result in poor blood circulation to the face, leading to underdevelopment of bone and muscle tissue.

Insufficient blood supplies during the early stages of pregnancy may cause hemifacial microsomia.
Insufficient blood supplies during the early stages of pregnancy may cause hemifacial microsomia.

Hemifacial microsomia primarily affects the formation of ears, the mandible, and the mouth, and can occur on one or both sides of the lower face. Teeth are prone to grow irregularly and facial nerves may not function properly, causing numbness and the inability to control facial movements. Microsomia can also cause one eye socket to be smaller than the other and slanted towards the cheek. It is common for infants to experience hearing and breathing problems, and severe cases may necessitate tracheotomies to allow newborns to breathe.

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Hemifacial microsomia may cause facial nerves not to function properly.
Hemifacial microsomia may cause facial nerves not to function properly.

Specialists known as craniofacial physicians and geneticists can diagnose the condition and rule out other possible afflictions by conducting physical examinations, taking x-rays, and performing computed tomography scans. Surgical treatment is usually postponed until an infant has the chance to develop more fully into childhood. Depending on the severity and location of deformities, a craniofacial surgeon may choose to graft bone tissue from a rib to form the jaw, or reshape ears, mouth, and cheeks using specialized procedures.

A specialist will be able to diagnose a baby with hemifacial microsomia using X-rays.
A specialist will be able to diagnose a baby with hemifacial microsomia using X-rays.

An individual may need to undergo several surgical procedures throughout his or her childhood and adolescence to improve the structure and function of his or her facial features. An expert surgeon may be able to allow a child with mild hemifacial microsomia to regain complete functioning, with only minor visible abnormalities. Children with severe deformities may face lifelong hearing, speaking, and movement problems, which can often be managed with hearing aids, ongoing speech therapy, and sessions with physical rehabilitation therapists.

Hemifacial microsomia can occur on one or both sides of the lower face.
Hemifacial microsomia can occur on one or both sides of the lower face.

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