Hemifacial microsomia, also known as craniofacial microsomia, is a congenital disorder that causes either one or both sides of the face to be underdeveloped. Hemifacial microsomia is the second most common congenital disorder affecting the face after cleft lip and palate. This condition most commonly affects one side of the face, more commonly the right side, and can involve the ear, soft tissue fulness, facial nerve function and the jaw bones. The condition may be mild with almost imperceptible asymmetry or severe with obvious asymmetry. In the most severe cases, patients with hemifacial microsomia have problems breathing and eating and may require a tracheostomy at birth. Patients with so called “isolated microtia” probably have the mildest form of hemifacial microsomia with a symmetrical or near-symmetrical face and an absent ear. Dr. Charles Thorne can perform surgical treatment for patients with hemifacial microsomia at his New York City practice.
“Dr. Charles Thorne and his team at the Lenox Hill Hospital can perform a variety of surgical treatments to improve facial symmetry, achieve normal occlusion and TMJ function, and enhance hearing.”
Severe hemifacial microsomia with underdevelopment of the right ear, soft tissue of the right cheek, facial nerve and the jaw bones on the right side.
Hemifacial Microsomia Causes
There is no known cause of craniofacial microsomia. We know that it occurs very early in pregnancy. We also know that it can be produced in animals by administering certain medications but these are not medications that humans would ever be prescribed. There has been no link to any specific medications or activities of the mother during pregnancy. The condition is generally NOT inherited but there are a few families around the world with more than one affected child which leads one to believe that there must be an inherited tendency or an inherited form of the condition.
During embryologic development, structures called the first and second brachial arches develop into the tissues of the face. In a healthy pregnancy, these structures will later develop into the jaws, the bone structure of the middle ear, the external ear, and the muscles that are used for chewing and facial expressions.
However, individuals with hemifacial microsomia experience a disruption in the formation of these facial features. Like microtia, hemifacial microsomia is tremendously variable. Some patients have facial asymmetry that is barely noticeable and others have severe asymmetry with absence of the ear, underdevelopment of the jaws. Underdevelopment of the soft tissue of the cheek and paralysis of some branches of the facial nerve. In fact, patients with microtia probably have hemifacial microsomia; it is just so mild that the facial asymmetry is not identified.
Treatments and Therapies
Hemifacial microsomia causes a wide range of difficulties. The patients who are severely affected require:
- Distraction of the short mandible early in childhood
- Fat grafting to the cheek or micosurgical reconstruction of the deficient cheek tissue
- Ear reconstructions
- Final jaw surgery
- Touchup fat grafting to the face
Dr. Thorne's team at the Lenox Hill Hospital can provide multi-disciplinary care for all stages of treatment.
Schedule Your Consultation
Dr. Charles Thorne has extensive experience helping patients improve their hearing and their appearance, and he wants to help you and your family. To learn more, or to schedule a personal consultation, contact our office today.