Hemifacial MIcrosomia
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  What is Hemifacial Microsomia?
Hemifacial Microsomia is a condition in which the lower half of one side of the face is underdeveloped and does not grow normally. It is sometimes 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 maldevelopment of the ear and the mandible. This is the second most common facial birth defect after clefts. Hemifacial microsomia is a condition in which the structures on one side of the face are smaller or underdeveloped and are not the same as the other side. The ear and the mandible are always affected although severity varies widely between individuals.
When both sides of the face are affected to different degrees, the condition is then referred to as bilateral hemifacial microsomia.
Why did this happen?
Researchers are still not sure why this happens, however, most agree that something occurred in the early stages of development such as a disturbance of the blood supply to the first and second branchial arches in the first 6 to 8 weeks of pregnancy. Studies do NOT link this condition with the mother's activities or actions during her pregnancy.
What are the different types of HFM?
The deformity in hemifacial microsomia varies greatly in the degree of severity and in the area of the face involved. The disorder varies from mild to severe. In the more severe cases, the following structures are underdeveloped:
>> The external and middle ear
>> The side of the skull
>> The thickness of the cheek tissue
>> The upper and lower jaws
>> The teeth
>> Some of the nerves that allow facial movement
In the milder forms, only some of the structures are affected and to a lesser degree.
How is HFM diagnosed?
HFM is typically diagnosed after a comprehensive medical history and physical examination by a plastic surgeon. There is no blood test to diagnose HFM. . CT scans and x-rays of the face may also be ordered for accurate diagnosis.

How is hemifacial microsomia treated?
>> The goal of treatment for children with hemifacial microsomia is to balance the appearance of the two sides of the face as much as possible.
>> Depending on the particular characteristics of a child's condition of a child's condition, surgery and/or orthodontics may be recommended.
>> Ear reconstruction begins at about 6-7 years of age and involves 3-4 surgeries.
>> Jaw reconstruction includes lengthening the lower jaw, sometimes using bone grafting or a distraction device
>> Routine hearing tests must be done to insure adequate hearing and to detect any loss which may require intervention.
>> A child with hemifacial microsomia may encounter social and emotional challenges unique to this condition. Support organizations and resources are available for children and their families