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V. face distortion

a) at birth (hemi facial microsomia)

Hemifacial microsomia is a condition in which half of one side of the face is underdeveloped and does not grow normally. It is also called craniofacial microsomia. The condition is sometimes confused with Goldenhar syndrome a rare congenital condition.

There is variety of deformities associated with HFM involving different parts of face in varying degree of severity and some areas may not be affected at all. In 10 to 15 percent of cases, both sides of the face are affected, often times asymmetrically.

commonly involved areas of face are;
  •  Orbit/Eye
  •  Jaws/mandible
  •  Ear (external & middle)
  •  Some of cranial nerves
  •  Side of the skull
  •  Cheek
  •  Teeth

Management of Hemifacial microsomia needs collaborative team approach which includes plastic surgeon, maxillofacial surgeons and dentists and orthodontists, anesthetist and pediatricians.

New born is initially evaluated for urgent problems and the managed with team collaboration

In severe form neonate may require urgent tracheostomy for breathing problems and surgery for eye support in case of exposure.

Definitive surgical intervention is divided in different age groups range from soft tissue reconstruction of lip, cheek, reconstruction of ear and bony reconstruction of mandible and jaw.

faq

If there is no associated brain problem, child is normal

It is treated in collaboration with other specialties dealing with urgent problems first. Then different surgeries are planned according to age of child.

Goldenhar syndrome is rare congenital condition resembling Hemi facial microsomia. It is characterized by abnormal development of the eye, ear and spine and lip. It can affect heart, kidneys, nervous system and lungs.

There is no "catch up" growth on the affected side of the face and that these patients always become more deformed with age. The psychological problems also increase with time and progression of the facial deformity. (copied from google)

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